Blood pressure (BP) control is vital to the management of patients with chronic kidney disease (CKD) yet most treatment decisions use BPs obtained in the clinic. The purpose of this report is to review the importance of self-measured and automatic ambulatory BPs in the management of patients with CKD. Compared with clinic - obtained BPs, self-measured BP more accurately defines hypertension in CKD. Masked hypertension seems to be associated with higher risk of end-stage renal disease in CKD patients. Conversely, white-coat hypertension seems to be associated with better renal outcomes than those who have persistent hypertension. Ambulatory BP monitoring is the only tool to monitor BP during sleep, diagnose nondipping, and, as self-measured BPs, have greater prognostic power in CKD compared with clinic BP. In hemodialysis patients, self-measured BP, but not pre/post-dialysis BP, shares the combination of high sensitivity and high specificity of greater than 80% to make a diagnosis of hypertension with the reference standard of ambulatory BP monitoring. In addition, self-measured and ambulatory BPs seem to be better correlates of left-ventricular hypertrophy and mortality in hemodialysis patients compared with pre/post-dialysis BP. Emerging data suggest that out-of-office BP monitoring is superior toBP obtained in the clinic when predicting target-organ damage and prognosis. Out-of-office BP monitoring is recommended for the management of hypertension in all stages of CKD.
- Ambulatory blood pressure monitoring
- Cardiovascular disease
- Chronic kidney disease
- Home blood pressure monitoring
ASJC Scopus subject areas
- Internal Medicine
- Cardiology and Cardiovascular Medicine
- Assessment and Diagnosis
- Advanced and Specialized Nursing
Out-of-office blood pressure monitoring in chronic kidney disease. / Agarwal, Rajiv; Peixoto, Aldo J.; Santos, Sergio F F; Zoccali, Carmine.In: Blood Pressure Monitoring, Vol. 14, No. 1, 02.2009, p. 2-11.
Research output: Contribution to journal › Article
TY - JOUR
T1 - Out-of-office blood pressure monitoring in chronic kidney disease
AU - Agarwal, Rajiv
AU - Peixoto, Aldo J.
AU - Santos, Sergio F F
AU - Zoccali, Carmine
PY - 2009/2
Y1 - 2009/2
N2 - Lippincott Williams & Wilkins.
AB - Lippincott Williams & Wilkins.
KW - Ambulatory blood pressure monitoring
KW - Cardiovascular disease
KW - Chronic kidney disease
KW - Home blood pressure monitoring
KW - Hypertension
UR - http://www.scopus.com/inward/record.url?scp=63449123500&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=63449123500&partnerID=8YFLogxK
U2 - 10.1097/MBP.0b013e3283262f58
DO - 10.1097/MBP.0b013e3283262f58
M3 - Article
VL - 14
SP - 2
EP - 11
JO - Blood Pressure Monitoring
JF - Blood Pressure Monitoring
SN - 1359-5237
IS - 1