Ambulatory BP Monitoring Can Predict Renal, Cardiac Risk

Nighttime ambulatory BP monitoring may predict renal and cardiac risks better than office BP

TUESDAY, June 28 (HealthDay News) -- In patients with chronic kidney disease (CKD), ambulatory blood pressure (BP) monitoring, especially at night, may predict renal and cardiovascular risks better than office BP measurements, according to a study published in the June 27 issue of the Archives of Internal Medicine.

Roberto Minutolo, M.D., Ph.D., from the Second University of Naples in Italy, and colleagues investigated whether ambulatory BP monitoring and office BP measurements could be used to predict fatal and nonfatal cardiovascular events and renal death in 436 patients with CKD (average age, 65.1 years). The participants were followed up for an average of 4.2 years. The time to renal death (end stage renal-disease or death), and time to fatal and non-fatal cardiovascular disease events were the main outcomes measured.

The investigators found that renal and cardiac end points were reached by 155 and 103 patients, respectively. Patients whose systolic BP (SBP) was 136 to 146 mm Hg and higher had an increased adjusted risk of the cardiovascular end points (hazard ratio [HR], 2.23, and 3.07, respectively) and renal death (HR, 1.72 and 1.85, respectively) than patients with a daytime SBP of 126 to 135 mm Hg. Compared to the nighttime SBP value of 106 to 114 mm Hg, SBPs of 125 to 137 mm Hg and higher at night also increased the risk of the cardiovascular (HR, 2.52 and 4.00, respectively) and renal end points (HR, 1.87 and 2.54, respectively). Office BP measurement did not predict the risk of either end point. Nondippers and reverse dippers were at greater risk for both the end points.

"In chronic kidney disease, ambulatory BP measurement and, in particular, nighttime BP measurement, allows more accurate prediction of renal and cardiovascular risk," the authors write.

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