Document Detail


Home blood pressure measurements for managing hypertension in hemodialysis patients.
MedLine Citation:
PMID:  19246891     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Home blood pressure (BP) monitoring serves as a practical method to detect changes in BP instead of ambulatory BP monitoring in hemodialysis patients. To evaluate the relationship of reduction in home BP compared to interdialytic ambulatory BP measurements we analyzed the data from the dry-weight reduction in hypertensive hemodialysis patients (DRIP) trial in which 100 patients had their dry weight probed based on clinical sign and symptoms and 50 patients served as controls. We measured home BP 3 times a day for 1 week using a validated oscillometric monitor on 3 occasions at 4-week intervals after randomization. Changes from baseline in home, predialysis BP and postdialysis BP were compared to interdialytic 44-hour ambulatory BP. Home and ambulatory BP monitoring was available in 141 of 150 (94%) patients. Predialysis systolic BP was not as sensitive as ambulatory BP in detecting change in BP with dry-weight reduction. Whereas postdialysis BP was capable of detecting an improvement in systolic BP in response to probing dry weight, by itself it does not provide evidence that change in postdialysis BP persists over the interdialytic period. Home BP reliably detected changes in ambulatory BP, albeit with less sensitivity at 4 weeks. However, at 4 and at 8 weeks, changes in home systolic BP were most strongly related to changes in interdialytic ambulatory systolic BP compared to predialysis and postdialysis BP. The reproducibility of BP measurements followed the order home > ambulatory >> predialysis > postdialysis. These data provide support for the use of home BP monitoring for the management of hypertension in hemodialysis patients.
Authors:
Rajiv Agarwal; Sangeetha Satyan; Pooneh Alborzi; Robert P Light; Getachew G Tegegne; Helmneh S Mazengia; Paulos M Yigazu
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-02-27
Journal Detail:
Title:  American journal of nephrology     Volume:  30     ISSN:  1421-9670     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-11-16     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  126-34     Citation Subset:  IM    
Copyright Information:
Copyright 2009 S. Karger AG, Basel.
Affiliation:
Division of Nephrology, Indiana University School of Medicine, Indianapolis, Ind., USA. ragarwal@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure
Blood Pressure Monitoring, Ambulatory / methods*
Female
Home Care Services
Humans
Hypertension / diagnosis,  physiopathology*
Kidney Failure, Chronic / physiopathology,  therapy
Male
Middle Aged
Randomized Controlled Trials as Topic
Renal Dialysis / methods*
Systole
Grant Support
ID/Acronym/Agency:
5R01-NIDDK062030-05//PHS HHS
Comments/Corrections
Comment In:
Curr Hypertens Rep. 2009 Oct;11(5):299-300   [PMID:  19737444 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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