Ambulatory blood pressure monitoring in children with aortic coarctation and kidney transplantation

Giordano, Ugo; Matteucci, Maria Chiara; Calzolari, A.; Turchetta, Attilio; Rizzoni, Gianfranco; Alpert, Bruce S.

doi:10.1016/s0022-3476(00)90016-7

Cited by 56 publications

(49 citation statements)

References 17 publications

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“…Our results are in line with those of other studies [11,16,17]. The prevalence of hypertension ranged between 62% and 75% vs 33% and 50% according to ABPM and casual data in the studies mentioned respectively.…”

Section: Discussionsupporting

confidence: 92%

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Blood pressure profile in renal transplant recipients and its relation to diastolic function: tissue Doppler echocardiographic study

et al. 2011

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Hypertension is a common complication after renal transplantation and is associated with increased risk of cardiovascular disease. The aim of the current study was to investigate the diurnal blood pressure pattern and its relation to structural and functional cardiac changes in renal transplant recipients. Sixty-six stable renal transplant patients (34 female, 32 male), aged 7 to 25 years (mean 17.4±4.3 years) were enrolled in this study. Cardiac function assessed by tissue Doppler echocardiography and blood pressure measurement performed using both the ambulatory and the casual method. Hypertension was demonstrated in 57% of recipients by the casual method and in 75.7% by ambulatory blood pressure monitoring (ABPM). The efficacy of BP control among patients on antihypertensive drugs was 60%. The prevalence of non-dipping was 73%. There was significant inverse correlation between systolic or diastolic day-time or night-time BP index and post-transplant duration (p<0.001, r=-0.386), but no correlation between ABP parameters and BMI, gender, and eGFR. There was a significant relationship between all ABP parameters and left ventricular mass index (LVMI) (p=0.025-0.007, r=0.28-0.38). LVMI was significantly higher in hypertensive than in normotensive cases (p=0.034). There was no difference in diastolic function between hypertensive and normotensive patients or between patients with and without left ventricular hypertrophy (LVH). In conclusion, our study showed the advantage of ABPM over the casual method of diagnosis of hypertension. LVH is common in transplant patients and is likely associated with arterial hypertension. Hypertension and LVH cannot differentiate transplant patients with diastolic malfunction.

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Section: Discussionsupporting

confidence: 92%

“…This is in agreement with the results of Morgan et al [11], Giordano et al [17], and Seeman et al [18]. This feature shows the advantage of ABPM in demonstrating abnormal BP during sleep and it means that night-time hypertension is always present in hypertensive renal transplant recipients.…”

Section: Discussionsupporting

confidence: 92%

Blood pressure profile in renal transplant recipients and its relation to diastolic function: tissue Doppler echocardiographic study

et al. 2011

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“…97 The prevalence of hypertension is even higher with ABPM, approaching 70%-80%. Studies show the prevalence of masked hypertension (normal office BP and elevated ABPM) was 50% greater than that identified using casual BP [98][99][100][101] and an increased prevalence of nondippers among children with kidney transplants. 101,102 A study by Polónia et al 103 concurs with other studies showing significant rates of nocturnal hypertension in pediatric transplant recipients and that a significant proportion of patients thought to be adequately controlled by medications still had masked hypertension.…”

Section: Hypertension In the Pediatric Transplant Recipient Or Recipimentioning

confidence: 96%

Assessment and Management of Hypertension in Transplant Patients

Weir

Burgess

Cooper

et al. 2015

Journal of the American Society of Nephrology

152

111

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Hypertension in renal transplant recipients is common and ranges from 50% to 80% in adult recipients and from 47% to 82% in pediatric recipients. Cardiovascular morbidity and mortality and shortened allograft survival are important consequences of inadequate control of hypertension. In this review, we examine the epidemiology, pathophysiology, and management considerations of post-transplant hypertension. Donor and recipient factors, acute and chronic allograft injury, and immunosuppressive medications may each explain some of the pathophysiology of post-transplant hypertension. As observed in other patient cohorts, renal artery stenosis and adrenal causes of hypertension may be important contributing factors. Notably, BP treatment goals for renal transplant recipients remain an enigma because there are no adequate randomized controlled trials to support a benefit from targeting lower BP levels on graft and patient survival. The potential for drugdrug interactions and altered pharmacokinetics and pharmacodynamics of the different antihypertensive medications need to be carefully considered. To date, no specific antihypertensive medications have been shown to be more effective than others at improving either patient or graft survival. Identifying the underlying pathophysiology and subsequent individualization of treatment goals are important for improving long-term patient and graft outcomes in these patients.

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“…In children with Riley-Day syndrome (familial dysautonomia), ABPM was able to identify the severe vasomotor instability with hypotension and hypertension during the day, with a preserved circadian rhythm in a study of three subjects [121]. Several authors have shown that, in children and adolescents after surgical repair of aortic coarctation, daytime hypertension was seen in roughly a third of these patients [122,123]. ABPM also found nocturnal hypertension in patients with daytime normotension in the larger of these studies [123].…”

Section: Additional Uses Of Abpmmentioning

confidence: 99%

Utility of ambulatory blood pressure monitoring in children and adolescents

Graves

Althaf

2006

Pediatr Nephrol

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Diagnosis of hypertension is critically dependent on accurate blood pressure measurement. "Accurate" refers to carefully following the guidelines for blood pressure measurement laid out for children and adults to minimize observer and subject errors that commonly occur in clinical blood pressure measurement. Accurate blood pressure measurement is more important in children and adolescents as the misdiagnosis of hypertension may have a life-long adverse impact on insurability and employment. Automated blood pressure measurement offers multiple advantages in achieving high-quality blood pressure determinations by reducing observer errors. The most commonly used form of automated blood pressure measurement is 24-h ambulatory blood pressure measurement (ABPM). Information on ABPM in children has grown exponentially over the last decade. Normative data exists for diagnosis of hypertension in children using ABPM including a novel method for determining normal values with the LMS method. There is further information about the utility of different determinants of 24-h blood pressure such as dipping status, morning surge and blood pressure load. ABPM has been able to detect significant differences in blood pressure in many disease states in children including chronic renal failure, polycystic kidney disease, solitary functioning kidney, and after renal transplantation. Increasingly nonambulatory automated blood pressure determinations have been used in management of hypertension in children. Although nonambulatory automated readings lack information about nocturnal blood pressure or blood pressure during daily activity, studies have suggested that home automated blood pressure measurements are a helpful adjunct to the usual office blood pressure reading.

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Ambulatory blood pressure monitoring in children with aortic coarctation and kidney transplantation

Cited by 56 publications

References 17 publications

Blood pressure profile in renal transplant recipients and its relation to diastolic function: tissue Doppler echocardiographic study

Blood pressure profile in renal transplant recipients and its relation to diastolic function: tissue Doppler echocardiographic study

Assessment and Management of Hypertension in Transplant Patients

Utility of ambulatory blood pressure monitoring in children and adolescents

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