Monitorización ambulatoria de presión arterial (MAPA) en enfermos jóvenes

Abstract

INTRODUCCIÓNLa MAPA es un elemento diagnóstico de extraordinario interés para la enfermedad más común que podemos encontrar en nuestra sociedad. Su uso se ha generalizado progresivamente en la práctica clínica tanto general como especializada. Además de sus utilidades desde el punto de vista experimental y para la investigación clínica (1,2), se han definido dos usos esenciales para la técnica. El primero de ellos es la confirmación del diagnóstico de HTA (o dicho al revés, la negación del diagnóstico 23 [0212-7199(2001) 18: 6; pp 305-308] ANALES DE MEDICINA INTERNA

Nighttime Blood Pressure Fall in Renal Disease Patients

“…These results are contradictory with some previous reports on nighttime BP patterns in renal disease patients, which founded abnormal reductions of BP in these subjects. [7,8,16,17] There are scanty reports about nocturnal blood pressure fall in renal patients previously to begin hemodialysis. Farmer et al studied a group of 26 diabetic nephropathy patients to evaluate the influence of nondipper status on chronic renal failure progression but they did not include a control group of nonrenal patients, so, differences about nocturnal BP drop could not be analyzed.…”

“…[9] In a previous report of a rather shorter sample of renal patients without control group we found a decreased nighttime BP fall. [17] The biggest study is a retrospective analysis of a total of 480 ambulatory blood pressure recordings in 380 patients with underlying renal disease. [8] Patients came from nephrology outpatient clinics, dialysis units (hemodialysis and peritoneal dialysis), and from renal transplant receptors.…”

“…[15] Among these causes, decreased fall in BP with sleep has been reported in patients with chronic renal diseases, such as IgA nephropathy, [7] and chronic renal failure. [8,16,17] But the experience collected is not homogeneous and there are some reports, which fail to find any abnormality of circadian BP rhythm in renal patients. [11,18] The objective of this study has been to confirm the abnormal reduction of BP during sleep in a broad group of patients with several forms renal disease and with (or without) associated renal failure and to investigate the possible causes of this phenomena and, specially, the effect of treatment on this problem.…”