Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

Ren Fail. 2015 Apr;37(3):446-51. doi: 10.3109/0886022X.2014.996730. Epub 2015 Jan 12.

Abstract

Although both clinic blood pressure (BP) variability and home BP variability are associated with the risk of cardiovascular disease, the relationship between both BP variabilities remain unclear. We evaluated the association between visit-to-visit variability of clinic BP (VVV) and day-by-day home BP variability (HBPV) in patients with chronic kidney disease (CKD). We recruited 143 CKD patients in whom we performed HBP measurements every morning and evening over seven consecutive days. We obtained clinic BP data during 9.6 ± 1.0 consecutive visits within 24 months. The associations between the variables of VVV and HPBV were examined. The CV values of clinic systolic BP (CSBP) was significantly correlated with the mean values of morning systolic BP (MSBP) and those of evening systolic BP (ESBP) (r = 0.23, 0.20; p = 0.007, 0.02, respectively). The CV values of CSBP was significantly correlated with the CV values of MSBP and those of ESBP (r = 0.19, 0.31; p = 0.02, <0.001, respectively). On the multivariate regression analysis, the CV values of CSBP was significantly correlated with the CV values of MSBP and those of ESBP [standardized regression coefficient (β) = 0.19, 0.34; p = 0.03, <0.001, respectively]. In conclusion, VVV showed a weak but significant association with HBPV, especially the CV values of ESBP in CKD patients. Further studies are necessary to clarify whether these different BPV elements will be alternative marker of BPV.

Keywords: Blood pressure variability; chronic kidney disease; home blood pressure measurement; visit-to-visit variability.

MeSH terms

  • Aged
  • Ambulatory Care / methods*
  • Ambulatory Care / statistics & numerical data
  • Antihypertensive Agents* / classification
  • Antihypertensive Agents* / therapeutic use
  • Blood Pressure / drug effects
  • Blood Pressure Monitoring, Ambulatory / methods*
  • Blood Pressure Monitoring, Ambulatory / statistics & numerical data
  • Disease Management
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / etiology
  • Hypertension* / physiopathology
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / physiopathology
  • Statistics as Topic

Substances

  • Antihypertensive Agents