Home blood pressure monitoring in CKD

Martin J. Andersen, Wassim Khawandi, Rajiv Agarwal

Research output: Contribution to journalArticle

87 Citations (Scopus)

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 languageEnglish
Pages (from-to)994-1001
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume45
Issue number6
DOIs
StatePublished - Jun 2005

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Ambulatory Blood Pressure Monitoring
Chronic Renal Insufficiency
Blood Pressure
Hypertension
Masked Hypertension
White Coat Hypertension
Galectin 3
Disease Progression

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 journalArticle

Andersen, Martin J. ; Khawandi, Wassim ; Agarwal, Rajiv. / Home blood pressure monitoring in CKD. In: American Journal of Kidney Diseases. 2005 ; Vol. 45, No. 6. pp. 994-1001.
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