Ambulatory Blood Pressure and Cardiovascular Events in Chronic Kidney Disease

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Hypertension is an important risk factor for adverse cardiovascular and renal outcomes, particularly in patients with chronic kidney disease (CKD). This review compares blood pressure (BP) measurements obtained in the clinic with those obtained outside the clinic to predict cardiovascular and renal injury and outcomes. Data are accumulating that suggest that ambulatory BP monitoring is a superior prognostic marker compared with BP values obtained in the clinic. The use of ambulatory BP monitoring can detect white-coat hypertension and masked hypertension, which results in less misclassification of BPs. Ambulatory BP monitoring is a marker of cardiovascular end points in CKD. Nondipping is associated with proteinuria and lower glomerular filtration rate. Although nondipping is associated with more end-stage renal disease and cardiovascular events, adjustment for other risk factors removes the prognostic significance of nondipping. For patients with CKD who are not on dialysis, 24-hour ambulatory BPs of less than 125/75 mm Hg, daytime ambulatory BP of less than 130/85 mm Hg, and nighttime ambulatory BPs of less than 110/70 mm Hg appear to be reasonable goal BP targets. In the management of hypertension in patients with CKD, control of hypertension is important. Ambulatory BP monitoring may be useful to assign more aggressive treatment to patients with masked hypertension and withdraw antihypertensive therapy in patients with white-coat hypertension. Ambulatory BP monitoring can refine cardiovascular and renal risk assessment in all stages of CKD. The independent prognostic role of nondipping is unclear.

Original languageEnglish (US)
Pages (from-to)538-543
Number of pages6
JournalSeminars in Nephrology
Volume27
Issue number5
DOIs
StatePublished - Sep 1 2007

Fingerprint

Ambulatory Blood Pressure Monitoring
Chronic Renal Insufficiency
Blood Pressure
Masked Hypertension
White Coat Hypertension
Hypertension
Kidney
Glomerular Filtration Rate
Proteinuria
Antihypertensive Agents
Chronic Kidney Failure
Dialysis
Wounds and Injuries
Therapeutics

Keywords

  • Ambulatory blood pressure monitoring
  • cardiovascular disease
  • chronic kidney disease
  • home blood pressure monitoring
  • hypertension

ASJC Scopus subject areas

  • Nephrology

Cite this

Ambulatory Blood Pressure and Cardiovascular Events in Chronic Kidney Disease. / Agarwal, Rajiv.

In: Seminars in Nephrology, Vol. 27, No. 5, 01.09.2007, p. 538-543.

Research output: Contribution to journalArticle

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