Home blood pressure measurements for managing hypertension in hemodialysis patients

Rajiv Agarwal, Sangeetha Satyan, Pooneh Alborzi, Robert P. Light, Getachew G. Tegegne, Helmneh S. Mazengia, Paulos M. Yigazu

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Home blood pressure (BP) monitoring serves as a practical method to detect changes in BP instead of ambulatory BP monitoring in hemodialysis patients. To evaluate the relationship of reduction in home BP compared to interdialytic ambulatory BP measurements we analyzed the data from the dry-weight reduction in hypertensive hemodialysis patients (DRIP) trial in which 100 patients had their dry weight probed based on clinical sign and symptoms and 50 patients served as controls. We measured home BP 3 times a day for 1 week using a validated oscillometric monitor on 3 occasions at 4-week intervals after randomization. Changes from baseline in home, predialysis BP and postdialysis BP were compared to interdialytic 44-hour ambulatory BP. Home and ambulatory BP monitoring was available in 141 of 150 (94%) patients. Predialysis systolic BP was not as sensitive as ambulatory BP in detecting change in BP with dry-weight reduction. Whereas postdialysis BP was capable of detecting an improvement in systolic BP in response to probing dry weight, by itself it does not provide evidence that change in postdialysis BP persists over the interdialytic period. Home BP reliably detected changes in ambulatory BP, albeit with less sensitivity at 4 weeks. However, at 4 and at 8 weeks, changes in home systolic BP were most strongly related to changes in interdialytic ambulatory systolic BP compared to predialysis and postdialysis BP. The reproducibility of BP measurements followed the order home > ambulatory ≫ predialysis > postdialysis. These data provide support for the use of home BP monitoring for the management of hypertension in hemodialysis patients.

Original languageEnglish (US)
Pages (from-to)126-134
Number of pages9
JournalAmerican journal of nephrology
Volume30
Issue number2
DOIs
StatePublished - Aug 2009

Keywords

  • Ambulatory blood pressure monitoring
  • Hemodialysis
  • Home blood pressure monitoring
  • Hypertension

ASJC Scopus subject areas

  • Nephrology

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    Agarwal, R., Satyan, S., Alborzi, P., Light, R. P., Tegegne, G. G., Mazengia, H. S., & Yigazu, P. M. (2009). Home blood pressure measurements for managing hypertension in hemodialysis patients. American journal of nephrology, 30(2), 126-134. https://doi.org/10.1159/000206698