Hypertension in Young Patients After Renal Transplantation Ambulatory Blood Pressure Monitoring Versus Casual Blood Pressure

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

doi:10.1016/s0895-7061(97)00484-6

Cited by 79 publications

(61 citation statements)

References 19 publications

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“…Although this definition neglects influence of hypertension on target organ damage [20], it was shown that ABPM enables detection of increased risk for ventricular hypertrophy in patients whose BP load is above 50% [21]. Investigators have also reported that there was a better correlation of ABPM readings with an increased risk of target organ damage than office BP measurements [22].…”

Section: Discussionmentioning

confidence: 99%

Masked hypertension and hidden uncontrolled hypertension after renal transplantation

et al. 2010

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Arterial hypertension is a risk factor affecting graft function in pediatric kidney transplants. Recent pediatric studies reported a high prevalence of hypertension, especially nocturnal hypertension in this population. Data regarding the prevalence of masked hypertension in pediatric patients with kidney transplants are still scarce. The aim of this cross-sectional study was to assess the prevalence of masked and hidden uncontrolled hypertension after renal transplantation. A total of 41 patients (25 males) with stable functioning renal graft were included in the study. Their median age was 14.5 years with the median interval since transplantation of 2.5 years (range 0.3 to 20.6). Spacelabs 90207 was used to measure ambulatory blood pressure (BP) during a 24-h period. Ambulatory hypertension was defined as mean systolic and/or diastolic BP index at day-time or nighttime >or=1. Masked hypertension was defined as normal office BP but daytime ambulatory hypertension in patients without antihypertensive medications. Hidden uncontrolled hypertension was defined as daytime ambulatory hypertension undetected by office BP measurements in treated patients. Antihypertensive medications were prescribed to 58%. Prevalence of nocturnal hypertension was 68%. On the basis of combination of office and ABPM masked hypertension and hidden uncontrolled hypertension was detected in 24% and 21% of the study population, respectively. Regular use of ambulatory blood pressure monitoring in transplanted patients enables detection of masked and hidden uncontrolled hypertension.

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Section: Discussionmentioning

confidence: 99%

Masked hypertension and hidden uncontrolled hypertension after renal transplantation

et al. 2010

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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: 94%

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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“…The use of repeated ambulatory blood pressure monitoring (ABPM) allows us to obtain more representative values of BP and to study the behavior of BP during activity and sleep [19,20,21,22]. Studies have suggested the utility of ABPM in a variety of chronic disease, including diabetes mellitus, postoperative monitoring of surgical repair of coarctation of the aorta, and after kidney transplantation.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure and cardiovascular involvement in children with neurofibromatosis type1

Lama

Graziano

Calabrese

et al. 2004

Pediatric Nephrology

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We evaluated blood pressure in a sample of patients with neurofibromatosis type 1 (NF1), using ambulatory blood pressure monitoring (ABPM), to determine whether ABPM, when compared with casual BP recordings, allowed the detection of a higher risk for hypertension. We also evaluated the correlation between BP and vascular abnormalities. We studied 69 NF1 patients (36 males and 33 females) with a mean age of 11+/-4 years, divided into group A, with 24-h mean systolic blood pressure (SBP) or diastolic blood pressure (DBP) <95th percentile, and group B, with mean SBP or DBP >95th percentile. Standard electrocardiography and M-mode, two-dimensional echocardiography were performed and all patients were in sinus rhythm. ABPM identified 11 hypertensive patients (16%); 5 had a mean SBP >95th percentile, 3 mean SBP-DBP >95th percentile, and 3 a mean DBP >95th percentile. Laboratory and other investigations to exclude secondary hypertension were normal. Cardiac abnormalities were found in 13 of the 69 patients (18.8%) with NF1. There were no significant clinical and cardiac differences between the normotensive and hypertensive group. Our data emphasize the importance of periodic ABPM in NF1 patients to diagnose hypertension early and avoid target organ damage and increased mortality.

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Hypertension in Young Patients After Renal Transplantation Ambulatory Blood Pressure Monitoring Versus Casual Blood Pressure

Cited by 79 publications

References 19 publications

Masked hypertension and hidden uncontrolled hypertension after renal transplantation

Masked hypertension and hidden uncontrolled hypertension after renal transplantation

Assessment and Management of Hypertension in Transplant Patients

Blood pressure and cardiovascular involvement in children with neurofibromatosis type1

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