Prevalence and clinical characteristics of renal transplant patients with true resistant hypertension

Arias-Rodríguez, Manuel; Fernández‐Fresnedo, Gema; Campistol, Josep M.; Marín, Rafael; Franco, Antônio; Gómez, E.; Cabello, Virginia; Díaz, Joan Manuel; Osorio, J.M.; Gallego, Roberto

doi:10.1097/hjh.0000000000000510

Cited by 13 publications

(11 citation statements)

References 29 publications

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“…In our data, 24.1% of patients were considered to have white‐coat HTN. This is nearly in agreement with previous studies where white‐coat effect was present in 20% to 40% . The concordance rates between office BP and ABPM change according to the studies.…”

Section: Discussionsupporting

confidence: 92%

“…In our study, 67.8% of patients were classified as nondippers. In many previous studies, nondipping pattern was reported to be between 25% and 90% . Loss of normal diurnal BP variation, which has been described to occur among patients with chronic kidney disease, has been associated with a greater rate of CVD events as well as progression of renal disease .…”

Section: Discussionmentioning

confidence: 98%

“…Posttransplant HTN is a multifactorial phenomenon and the known causes of HTN include immunosuppressive drugs, renal graft artery stenosis, recipient's native kidney, allograft dysfunction, obesity, recurrent or de novo renal disease, and genetic factors . However, optimal office and ambulatory BP targets have not been well‐defined in the renal transplant populatıon and there is variance depending on the cutoffs and series …”

Section: Discussionmentioning

confidence: 99%

“…15 However, optimal office and ambulatory BP targets have not been well-defined in the renal transplant populatıon and there is variance depending on the cutoffs and series. 16,17 Some studies comparing both methods--office BP and ABPM--among nontransplant populations have shown BP values at home to be lower than those obtained in the office. 18,19 The difference between the two methods may be the result of the white-coat effect, an elevation of BP in a clinic setting leading to possible overestimation of true BP.…”

Section: Discussionmentioning

confidence: 99%

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Ambulatory Blood Pressure Monitoring and Echocardiographic Findings in Renal Transplant Recipients

Demirkol

Oruç

İkitimur

et al. 2015

J of Clinical Hypertension

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Hypertension is common in renal transplant recipients (RTRs). Ambulatory blood pressure (BP) monitoring (ABPM) is important in diagnosing hypertension and diurnal BP variation. The authors set out to compare office BP and ABPM measurements to determine diurnal pattern and to evaluate echocardiographic findings in RTRs. ABPM and office BP measurements were compared in 87 RTRs. Echocardiographic evaluation was performed for each patient. The correlations between office and 24-hour ABPM were 0.275 for mean systolic BP (P=.011) and 0.260 for mean diastolic BP (P=.017). Only 36.8% had concordant hypertension between office BP and ABPM, with a masked hypertension rate of 16.1% and white-coat effect rate of 24.1%. Circadian BP patterns showed a higher proportion of nondippers (67.8%). Left ventricular mass index was increased in 21.8% of all recipients. There was a significant but weak correlation between office BP and ABPM. J Clin Hypertens (Greenwich). 2016;18:766-771. ª 2015 Wiley Periodicals, Inc.Hypertension (HTN) is a prevalent disorder in renal transplant recipients (RTRs) and is considered one of the major risk factors for the development of cardiovascular disease (CVD).1 CVD represents the single most frequent cause of death in RTRs, accounting for approximately 40% of all-cause mortality. 2Diagnosis of HTN has traditionally been based on measurements of blood pressure (BP) in the office or clinic. However, inadequate BP control may occur when office BP is used as the only method to monitor BP and drug adjustment.3 Ambulatory BP monitoring (ABPM) has recently gained popularity in more accurately diagnosing HTN and predicting outcome in hypertensive patients and those with chronic kidney disease.4 It has been shown that ABPM can predict left ventricular hypertrophy (LVH), mortality and morbidity, and progression toward end-stage renal disease better than BP in patients with CKD. 5,6 In addition to accurate BP measurement, one of the variables measured by ABPM is diurnal BP variation. However, the optimal method for monitoring BP in RTRs remains unclear.In our study, we compared office and ABPM measurements to determine the diurnal BP pattern and to assess the relationship between BP parameters and echocardiographic findings in RTRs. MATERIALS AND METHODS Study PatientsWe examined 498 consecutive adult RTRs (age ≥18 years) in whom the duration of transplantation was more than 1 year. The following exclusion criteria were used: history of diabetes mellitus, heart failure, ischemic heart disease, cardiomyopathy, or significant valvular heart disease; active infection; a serum creatinine level >1.5 mg/dL; or hemoglobin level <10 g/dL. Of the remaining 150 RTRs, 60 refused to participate in the study and three did not show up for the echocardiography appointment. Thus, 87 patients completed the study. Study ProtocolDemographic (age and sex) and clinical (etiology of previous renal disease, date of transplant, donor type, height, and weight) data and previous renal replacement therapy (type and duration) records were...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ambulatory Blood Pressure Monitoring and Echocardiographic Findings in Renal Transplant Recipients

Demirkol

Oruç

İkitimur

et al. 2015

J of Clinical Hypertension

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“…The presence of an atherosclerotic RAS, even a less than 50% stenosis, is accompanied by a high risk of cardiovascular complications as compared to hypertension without RAS (8, 13, 16–18). A cohort of patients with RAS, detected at the time of coronary angiography, showed a 4-year survival rate of 65% as opposed to 86% for those without RAS (16).…”

Section: Discussionmentioning

confidence: 99%

The Use of the Ambulatory Arterial Stiffness Index in Patients Suspected of Secondary Hypertension

Verbakel

Adiyaman

Kraayvanger

et al. 2016

Front. Cardiovasc. Med.

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The ambulatory arterial stiffness index (AASI) is a marker of arterial stiffness and is derived from ambulatory 24-h blood pressure registration. We studied whether the AASI could be used as a predictive factor for the presence of renal artery stenosis (RAS) in patients with a suspicion of secondary hypertension and as such as a diagnostic tool for RAS. We included 169 patients with difficult-to-treat hypertension. They all underwent 24-h ambulatory blood pressure monitoring registration, imaging of the renal arteries, and cardiovascular risk measurement, including smoking, history, biometrics, blood pressure, renal function, lipids, and glucose metabolism. Performing univariate and multivariate analyses, we investigated if AASI and the other cardiovascular risk factors were related to the presence of RAS. Of the 169 patients (49% women), 31% had RAS. The mean AASI was 0.44 (0.16). The presence of RAS showed no significant correlation with AASI (r = 0.14, P = 0.06). Age (r = 0.19, P = 0.01), hypercholesterolemia (r = 0.26, P = 0.001), history of CVD (r = 0.22, P = 0.004), and creatinine clearance (r = −0.34, P < 0.001) all demonstrated a correlation with RAS. Although AASI is higher in patients with RAS, AASI does not independently predict the presence of RAS in hypertensive subjects.

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Antihypertensive treatment for kidney transplant recipients

Natale,

Mooi,

Green

et al. 2024

Cochrane Database of Systematic Reviews

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Prevalence and clinical characteristics of renal transplant patients with true resistant hypertension

Cited by 13 publications

References 29 publications

Ambulatory Blood Pressure Monitoring and Echocardiographic Findings in Renal Transplant Recipients

Ambulatory Blood Pressure Monitoring and Echocardiographic Findings in Renal Transplant Recipients

The Use of the Ambulatory Arterial Stiffness Index in Patients Suspected of Secondary Hypertension

Antihypertensive treatment for kidney transplant recipients

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