Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy

Rajiv Agarwal, Neva J. Brim, Jothiharan Mahenthiran, Martin J. Andersen, Chandan Sana

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

Blood pressures (BPs) obtained in the dialysis unit correlate poorly with ambulatory BP and left-ventricular hypertrophy (LVH). We compared the performance of BP obtained within and outside the dialysis unit as a correlate of LVH. BP was obtained in the dialysis unit using routine and standardized methods and outside the dialysis unit using home and ambulatory BP monitoring in 140 patients (mean age, 56 years; 89 men; 129 blacks; and 59 with diabetes mellitus) on chronic hemodialysis for >3 months. Dialysis unit BP recordings were averaged over 2 weeks, and home BP averaged over 1 week. Ambulatory BP monitoring was performed during an interdialytic interval. Echocardiography was performed immediately after dialysis for the assessment of left-ventricular mass. Left ventricular mass/height2.7 of >51 g/m2 was taken as evidence of LVH. Test performance of various BPs was compared using receiver operating characteristic curves. Average ambulatory BP was 129.7±21.2/73.6±13.1 mm Hg, home BP was 139.4±21.2/79. 0±12.5 mm Hg, standardized predialysis BP was 142.1±21.7/74. 9±13.3 mm Hg, postdialysis was 120.9±20.8/69.6±12.5 mm Hg, routine predialysis was 145.6±20.7/ 79.4±13.1 mm Hg, and postdialysis was 132.0±19.3/72.6±11.1 mm Hg. Left ventricular mass/height2.7 was 59.1±16.5, and 68% had LV hypertrophy. Diastolic BP measured by any technique was not associated with LVH. Routine and standardized measurements of BP were similarly weak correlates of LVH. Systolic BP outside the dialysis unit was a stronger correlate of LVH compared with dialysis unit BP.

Original languageEnglish
Pages (from-to)62-68
Number of pages7
JournalHypertension
Volume47
Issue number1
DOIs
StatePublished - Jan 2006

Fingerprint

Left Ventricular Hypertrophy
Renal Dialysis
Blood Pressure
Dialysis
Ambulatory Blood Pressure Monitoring
ROC Curve
Hypertrophy
Echocardiography

Keywords

  • Blood pressure
  • Blood pressure monitoring, ambulatory
  • Cross-sectional studies
  • Hypertension
  • Hypertrophy

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy. / Agarwal, Rajiv; Brim, Neva J.; Mahenthiran, Jothiharan; Andersen, Martin J.; Sana, Chandan.

In: Hypertension, Vol. 47, No. 1, 01.2006, p. 62-68.

Research output: Contribution to journalArticle

Agarwal, Rajiv ; Brim, Neva J. ; Mahenthiran, Jothiharan ; Andersen, Martin J. ; Sana, Chandan. / Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy. In: Hypertension. 2006 ; Vol. 47, No. 1. pp. 62-68.
@article{d0e180138ddf43429ef5b4727ea1cdbe,
title = "Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy",
abstract = "Blood pressures (BPs) obtained in the dialysis unit correlate poorly with ambulatory BP and left-ventricular hypertrophy (LVH). We compared the performance of BP obtained within and outside the dialysis unit as a correlate of LVH. BP was obtained in the dialysis unit using routine and standardized methods and outside the dialysis unit using home and ambulatory BP monitoring in 140 patients (mean age, 56 years; 89 men; 129 blacks; and 59 with diabetes mellitus) on chronic hemodialysis for >3 months. Dialysis unit BP recordings were averaged over 2 weeks, and home BP averaged over 1 week. Ambulatory BP monitoring was performed during an interdialytic interval. Echocardiography was performed immediately after dialysis for the assessment of left-ventricular mass. Left ventricular mass/height2.7 of >51 g/m2 was taken as evidence of LVH. Test performance of various BPs was compared using receiver operating characteristic curves. Average ambulatory BP was 129.7±21.2/73.6±13.1 mm Hg, home BP was 139.4±21.2/79. 0±12.5 mm Hg, standardized predialysis BP was 142.1±21.7/74. 9±13.3 mm Hg, postdialysis was 120.9±20.8/69.6±12.5 mm Hg, routine predialysis was 145.6±20.7/ 79.4±13.1 mm Hg, and postdialysis was 132.0±19.3/72.6±11.1 mm Hg. Left ventricular mass/height2.7 was 59.1±16.5, and 68{\%} had LV hypertrophy. Diastolic BP measured by any technique was not associated with LVH. Routine and standardized measurements of BP were similarly weak correlates of LVH. Systolic BP outside the dialysis unit was a stronger correlate of LVH compared with dialysis unit BP.",
keywords = "Blood pressure, Blood pressure monitoring, ambulatory, Cross-sectional studies, Hypertension, Hypertrophy",
author = "Rajiv Agarwal and Brim, {Neva J.} and Jothiharan Mahenthiran and Andersen, {Martin J.} and Chandan Sana",
year = "2006",
month = "1",
doi = "10.1161/01.HYP.0000196279.29758.f4",
language = "English",
volume = "47",
pages = "62--68",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Out-of-hemodialysis-unit blood pressure is a superior determinant of left ventricular hypertrophy

AU - Agarwal, Rajiv

AU - Brim, Neva J.

AU - Mahenthiran, Jothiharan

AU - Andersen, Martin J.

AU - Sana, Chandan

PY - 2006/1

Y1 - 2006/1

N2 - Blood pressures (BPs) obtained in the dialysis unit correlate poorly with ambulatory BP and left-ventricular hypertrophy (LVH). We compared the performance of BP obtained within and outside the dialysis unit as a correlate of LVH. BP was obtained in the dialysis unit using routine and standardized methods and outside the dialysis unit using home and ambulatory BP monitoring in 140 patients (mean age, 56 years; 89 men; 129 blacks; and 59 with diabetes mellitus) on chronic hemodialysis for >3 months. Dialysis unit BP recordings were averaged over 2 weeks, and home BP averaged over 1 week. Ambulatory BP monitoring was performed during an interdialytic interval. Echocardiography was performed immediately after dialysis for the assessment of left-ventricular mass. Left ventricular mass/height2.7 of >51 g/m2 was taken as evidence of LVH. Test performance of various BPs was compared using receiver operating characteristic curves. Average ambulatory BP was 129.7±21.2/73.6±13.1 mm Hg, home BP was 139.4±21.2/79. 0±12.5 mm Hg, standardized predialysis BP was 142.1±21.7/74. 9±13.3 mm Hg, postdialysis was 120.9±20.8/69.6±12.5 mm Hg, routine predialysis was 145.6±20.7/ 79.4±13.1 mm Hg, and postdialysis was 132.0±19.3/72.6±11.1 mm Hg. Left ventricular mass/height2.7 was 59.1±16.5, and 68% had LV hypertrophy. Diastolic BP measured by any technique was not associated with LVH. Routine and standardized measurements of BP were similarly weak correlates of LVH. Systolic BP outside the dialysis unit was a stronger correlate of LVH compared with dialysis unit BP.

AB - Blood pressures (BPs) obtained in the dialysis unit correlate poorly with ambulatory BP and left-ventricular hypertrophy (LVH). We compared the performance of BP obtained within and outside the dialysis unit as a correlate of LVH. BP was obtained in the dialysis unit using routine and standardized methods and outside the dialysis unit using home and ambulatory BP monitoring in 140 patients (mean age, 56 years; 89 men; 129 blacks; and 59 with diabetes mellitus) on chronic hemodialysis for >3 months. Dialysis unit BP recordings were averaged over 2 weeks, and home BP averaged over 1 week. Ambulatory BP monitoring was performed during an interdialytic interval. Echocardiography was performed immediately after dialysis for the assessment of left-ventricular mass. Left ventricular mass/height2.7 of >51 g/m2 was taken as evidence of LVH. Test performance of various BPs was compared using receiver operating characteristic curves. Average ambulatory BP was 129.7±21.2/73.6±13.1 mm Hg, home BP was 139.4±21.2/79. 0±12.5 mm Hg, standardized predialysis BP was 142.1±21.7/74. 9±13.3 mm Hg, postdialysis was 120.9±20.8/69.6±12.5 mm Hg, routine predialysis was 145.6±20.7/ 79.4±13.1 mm Hg, and postdialysis was 132.0±19.3/72.6±11.1 mm Hg. Left ventricular mass/height2.7 was 59.1±16.5, and 68% had LV hypertrophy. Diastolic BP measured by any technique was not associated with LVH. Routine and standardized measurements of BP were similarly weak correlates of LVH. Systolic BP outside the dialysis unit was a stronger correlate of LVH compared with dialysis unit BP.

KW - Blood pressure

KW - Blood pressure monitoring, ambulatory

KW - Cross-sectional studies

KW - Hypertension

KW - Hypertrophy

UR - http://www.scopus.com/inward/record.url?scp=31844435160&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=31844435160&partnerID=8YFLogxK

U2 - 10.1161/01.HYP.0000196279.29758.f4

DO - 10.1161/01.HYP.0000196279.29758.f4

M3 - Article

VL - 47

SP - 62

EP - 68

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 1

ER -