Abstract
Background: Blood pressure (BP) control is the mainstay of stalling the progression of cardiorenal disease, yet the performance characteristics of BPs obtained in the clinic (CBPs) by routine or standardized methods or at home (HBP) in diagnosing hypertension or assessing its control are unknown. Methods: Two hundred thirty-two patients (20% black; 4% women; mean age, 67 years; 35% with diabetes) with chronic kidney disease (CKD) underwent a single 24-hour ambulatory BP (ABP) monitoring (ABPM) and concomitant recording of CBP and HBP for 1 week. Hypertension is defined as systolic BP of 130 mm Hg or greater or diastolic BP of 80 mm Hg or greater on average awake 24-hour ABPM. Results: Average ABP was 135.2 ± 15.9/75.6 ± 11.0 mm Hg. Thirty-five percent of patients had isolated systolic hypertension; 3%, isolated diastolic hypertension; 27%, combined systolic and diastolic hypertension; and 35%, normotension or well-controlled BP. The prevalence of "white-coat effect" was estimated as 28% to 30% by means of CBPs and 24% by means of HBPs. Well-controlled BP in the clinic, but poorly controlled BP by means of ABPM, masked hypertension, was seen in 26% to 29% by means of CBPs, but only 13% with HBP monitoring. Conclusion: In patients with CKD, HBP is superior in reducing the misclassification of hypertension caused by the white-coat effect and masked hypertension commonly seen with CBPs. An average HBP of approximately 140/80 mm Hg appears to be the best correlate of hypertension defined by means of ABPM.
| Original language | English |
|---|---|
| Pages (from-to) | 994-1001 |
| Number of pages | 8 |
| Journal | American Journal of Kidney Diseases |
| Volume | 45 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2005 |
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Keywords
- Ambulatory blood pressure
- Chronic kidney disease (CKD)
- Home blood pressure
ASJC Scopus subject areas
- Nephrology
Cite this
Home blood pressure monitoring in CKD. / Andersen, Martin J.; Khawandi, Wassim; Agarwal, Rajiv.
In: American Journal of Kidney Diseases, Vol. 45, No. 6, 06.2005, p. 994-1001.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Home blood pressure monitoring in CKD
AU - Andersen, Martin J.
AU - Khawandi, Wassim
AU - Agarwal, Rajiv
PY - 2005/6
Y1 - 2005/6
N2 - Background: Blood pressure (BP) control is the mainstay of stalling the progression of cardiorenal disease, yet the performance characteristics of BPs obtained in the clinic (CBPs) by routine or standardized methods or at home (HBP) in diagnosing hypertension or assessing its control are unknown. Methods: Two hundred thirty-two patients (20% black; 4% women; mean age, 67 years; 35% with diabetes) with chronic kidney disease (CKD) underwent a single 24-hour ambulatory BP (ABP) monitoring (ABPM) and concomitant recording of CBP and HBP for 1 week. Hypertension is defined as systolic BP of 130 mm Hg or greater or diastolic BP of 80 mm Hg or greater on average awake 24-hour ABPM. Results: Average ABP was 135.2 ± 15.9/75.6 ± 11.0 mm Hg. Thirty-five percent of patients had isolated systolic hypertension; 3%, isolated diastolic hypertension; 27%, combined systolic and diastolic hypertension; and 35%, normotension or well-controlled BP. The prevalence of "white-coat effect" was estimated as 28% to 30% by means of CBPs and 24% by means of HBPs. Well-controlled BP in the clinic, but poorly controlled BP by means of ABPM, masked hypertension, was seen in 26% to 29% by means of CBPs, but only 13% with HBP monitoring. Conclusion: In patients with CKD, HBP is superior in reducing the misclassification of hypertension caused by the white-coat effect and masked hypertension commonly seen with CBPs. An average HBP of approximately 140/80 mm Hg appears to be the best correlate of hypertension defined by means of ABPM.
AB - Background: Blood pressure (BP) control is the mainstay of stalling the progression of cardiorenal disease, yet the performance characteristics of BPs obtained in the clinic (CBPs) by routine or standardized methods or at home (HBP) in diagnosing hypertension or assessing its control are unknown. Methods: Two hundred thirty-two patients (20% black; 4% women; mean age, 67 years; 35% with diabetes) with chronic kidney disease (CKD) underwent a single 24-hour ambulatory BP (ABP) monitoring (ABPM) and concomitant recording of CBP and HBP for 1 week. Hypertension is defined as systolic BP of 130 mm Hg or greater or diastolic BP of 80 mm Hg or greater on average awake 24-hour ABPM. Results: Average ABP was 135.2 ± 15.9/75.6 ± 11.0 mm Hg. Thirty-five percent of patients had isolated systolic hypertension; 3%, isolated diastolic hypertension; 27%, combined systolic and diastolic hypertension; and 35%, normotension or well-controlled BP. The prevalence of "white-coat effect" was estimated as 28% to 30% by means of CBPs and 24% by means of HBPs. Well-controlled BP in the clinic, but poorly controlled BP by means of ABPM, masked hypertension, was seen in 26% to 29% by means of CBPs, but only 13% with HBP monitoring. Conclusion: In patients with CKD, HBP is superior in reducing the misclassification of hypertension caused by the white-coat effect and masked hypertension commonly seen with CBPs. An average HBP of approximately 140/80 mm Hg appears to be the best correlate of hypertension defined by means of ABPM.
KW - Ambulatory blood pressure
KW - Chronic kidney disease (CKD)
KW - Home blood pressure
UR - http://www.scopus.com/inward/record.url?scp=20444376188&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20444376188&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2005.02.015
DO - 10.1053/j.ajkd.2005.02.015
M3 - Article
C2 - 15957127
AN - SCOPUS:20444376188
VL - 45
SP - 994
EP - 1001
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 6
ER -