title: Ambulatory vs office blood pressure monitoring in renal transplant recipients.
abstract: Hypertension is common following renal transplantation and has adverse effects on cardiovascular and graft health. Ambulatory blood pressure monitoring (ABPM) is better at overall blood pressure (BP) assessment and is necessary to diagnose nocturnal hypertension, which is also implicated in poor outcomes. The authors performed a retrospective analysis of 98 renal transplant recipients (RTRs) and compared office BP and ambulatory BP recordings. ABPM revealed discordance between office BP and ambulatory BP in 61% of patients, with 3% caused by white-coat and 58% caused by masked hypertension (of which 33% were caused by isolated nocturnal hypertension). Overall, mean systolic BP was 3.6 mm Hg (0.5-6.5) and diastolic BP was 7.5 mm Hg (5.7-9.3) higher via ambulatory BP than office BP. This was independent of estimated glomerular filtration rate, proteinuria, transplant time/type, and comorbidities. A total of 42% of patients had their management changed after results from ABPM. ABPM should be routinely offered as part of hypertension management in RTRs.
authors.affiliation: Department of Renal medicine, North Shore Hospital, Waitemata District Health Board, Takapuna, Auckland, New Zealand.
authors.forename: Jafar
authors.initials: J
authors.lastname: Ahmed
authors.forename: Valerie
authors.initials: V
authors.lastname: Ozorio
authors.forename: Maritza
authors.initials: M
authors.lastname: Farrant
authors.forename: Walter
authors.initials: W
authors.lastname: Van Der Merwe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D009819:Office Visits; D012189:Retrospective Studies; D066027:Transplant Recipients; D059466:White Coat Hypertension / Q000175:diagnosis / Q000503:physiopathology