Association of home blood pressure variability with progression of chronic kidney disease

Okada, Tomonari; Matsumoto, Hiroshi; Nagaoka, Yume; Nakao, Toshiyuki

doi:10.1097/mbp.0b013e32834f7125

Cited by 32 publications

(20 citation statements)

References 29 publications

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“…Notably, the SD and CV values of HBP in the current study were almost similar to those of previous studies. 1,4,14,35,36,43 The CV values of clinic BP in our study were also almost similar to those of previous studies. 6,17,18 Third, the study population had different numbers and classes of antihypertensive drugs as well as different underlying renal diseases.…”

Section: Discussionsupporting

confidence: 80%

“…Although few data were available regarding HBPV reproducibility, our previous study has shown a significant correlation between the BPV of HBP measurements at baseline and those during the follow-up period in CKD patients. 36,43 Therefore, some populations might have the characteristics of consistently high BPV.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have used one BP value on each occasion at home or in the clinic. 1,40,43 For a more definitive BP evaluation, it is recommendable to have 2 or more measurements of BP. Notably, the SD and CV values of HBP in the current study were almost similar to those of previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

et al. 2015

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Although both clinic blood pressure (BP) variability and home BP variability are associated with the risk of cardiovascular disease, the relationship between both BP variabilities remain unclear. We evaluated the association between visit-to-visit variability of clinic BP (VVV) and day-by-day home BP variability (HBPV) in patients with chronic kidney disease (CKD). We recruited 143 CKD patients in whom we performed HBP measurements every morning and evening over seven consecutive days. We obtained clinic BP data during 9.6 ± 1.0 consecutive visits within 24 months. The associations between the variables of VVV and HPBV were examined. In conclusion, VVV showed a weak but significant association with HBPV, especially the CV values of ESBP in CKD patients. Further studies are necessary to clarify whether these different BPV elements will be alternative marker of BPV.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

et al. 2015

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“…19 By contrast, a recent study reported that day-by-day BP variability, as assessed by home BP measurements, had no significant association with the progression of chronic kidney disease. 20 In line with this finding, the current study by Hoshide et al 21 of Kario's Laboratory, which was performed as a posthoc sub-analysis of the Japan Morning SurgeTarget Organ Protection (J-TOP) study, failed to find a significant association between the improvement in home BP variability and the reduction of normo-and microalbuminuria (baseline UAE mg g À1 creatine (interquartile range), 18.9 (9.1-48.5)), in spite of a significant association between home BP variability and UAE at baseline, and questioned the clinical relevance of home BP variability in the progression of albuminuria, in a range of normo-to microalbuminuria in hypertensive patients. The findings by Hoshide et al would be also consistent with a previous report from the same Kario's Laboratory showing a relatively weak association between home BP variability and albuminuria in a range of normo-to microalbuminuria, which is in contrast to the strong association that has been observed between home BP variability and cardiac hypertrophy in a cross-sectional study.…”

Section: T He Accumulated Results Of Clinical Trialsmentioning

confidence: 99%

Questionable link between normo- to microalbuminuria and home-measured blood pressure variability in hypertension

Tamura

Shibuya²,

Takeshita

et al. 2012

Hypertens Res

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“…47,48 Based on these findings, some authors have proposed visit-to-visit BPV in systolic BP as a novel risk factor for progression of diabetic nephropathy or development of albuminuria in patients with type 2 diabetes mellitus. 47 When focusing on CKD populations, whether or not with diabetes mellitus, several studies, but not all, 55,56 have shown increasing values of day-by-day home BPV to be significant predictors of development and progression of nephropathy. 57,58 Finally, in a recent retrospective analysis of a community-based cohort of 114 900 adults with CKD stages 3 to 4, increasing values of visit-to-visit BPV (defined as coefficient of variation, SD, or average real variability) were associated with higher risk of death, incident-treated ESRD, and cardiovascular events.…”

Section: Midterm Bpv (Day-by-day Assessment By Hbpm) Long-term (Visimentioning

confidence: 99%

Hypertension in Chronic Kidney Disease Part 2

et al. 2016

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Blood pressure (BP) is characterized by high variability, including changes beat-to-beat (very short term), within 24 hours (short term), from day to day (midterm), and between visits spaced by weeks, months, seasons, and even years (long term). These variations can be estimated by means of continuous beat-to-beat BP recordings, repeated conventional office BP measures, 24-hour ambulatory BP monitoring (ABPM), or home BP monitoring (HBPM) over longer time windows (Table). A main advantage of ABPM over other BP measurement techniques is represented by its ability to track BP changes occurring in daily life conditions and during 24 hours, thus allowing assessment of overall BP variability (BPV) as well as identification of its specific components, such as nocturnal hypertension and altered day-to-night BP profiles (ie, morning BP rise, nondipping pattern of BP) which become manifest early in the course of chronic kidney disease (CKD). These alterations are even more significant in subjects with end-stage renal disease (ESRD) mainly, but not exclusively, because of the marked reduction in intravascular volume immediately after hemodialysis followed by the progressive increase in volemia throughout the interdialytic period, 2 combined with an enhanced sympathetic activity. The higher frequency of alterations in 24-hour BP profiles and BPV in subjects with CKD and in those with ESRD not only makes a proper assessment and achievement of BP control more difficult in these subjects but may be prognostically relevant on the background of the evidence from longitudinal and observational studies indicating that increased BPV may predict the development of cardiovascular and renal disease, over and above the contribution of elevated mean BP levels per se 3-11 ( Figure 1). The purpose of this review is to address the currently available evidence on the role of ABPM and HBPM for the assessment and management of alterations in circadian BP profiles and in BPV in patients with CKD. Mechanisms of BPVIn physiological conditions, BP fluctuations occurring on a beat-by-beat basis and within the 24 hours may represent a homeostatic response of neural (ie, central sympathetic drive and its reflex modulation by arterial and cardiopulmonary reflexes), humoral (catecholamines, insulin, angiotensin II, bradykinin, endothelin-1, and nitric oxide), vascular (ie, elastic properties of arteries), and rheological mechanisms (ie, blood viscosity) to environmental (weather changes), behavioral (ie, physical activity, sleep, postural changes), and emotional (ie, psychological stress) stimuli.

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Association of home blood pressure variability with progression of chronic kidney disease

Abstract: Day-by-day BP variability as assessed by HBP measurements had no significant association with the progression of CKD.

Cited by 32 publications

References 29 publications

Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

Questionable link between normo- to microalbuminuria and home-measured blood pressure variability in hypertension

Hypertension in Chronic Kidney Disease Part 2

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