Discrepancies in clinic and ambulatory blood pressure in korean chronic kidney disease patients

Yun Kyu Oh, Ho Jun Chin, Shin Young Ahn, Jung Nam An, Jung Pyo Lee, Chun Soo Lim, Kook Hwan Oh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Blood pressure (BP) control is considered the most important treatment for preventing chronic kidney disease (CKD) progression and associated cardiovascular complications. However, clinic BP is insufficient to diagnose hypertension (HT) and to monitor overall BP control because it does not correlate well with ambulatory blood pressure monitoring (ABPM). We enrolled 387 hypertensive CKD patients (stages G1-G4, 58.4% male with median age 61 years) from 3 hospitals in Korea. HT of clinic BP and ABPM was classified as ≥ 140/90 and ≥ 130/80 mmHg, respectively. Clinic BP control rate was 60.2%. The median 24-hour systolic blood pressures (SBPs) of CKD G3b and CKD G4 were significantly higher than those of CKD G1-2 and CKD G3a. However, the median 24-hour SBPs were not different between CKD G1-2 and CKD G3a or between CKD G3b and CKD G4. Of all patients, 5.7%, 38.0%. 42.3%, and 14.0% were extreme-dippers, dippers, non-dippers, and reverse-dippers, respectively. Non-/reverse-dippers independently correlated with higher Ca × P product, higher intact parathyroid hormone (iPTH), and lower albumin. Normal BP was 33.3%, and sustained, masked, and white-coat HT were 29.7%, 26.9%, and 10.1%, respectively. White-coat HT independently correlated with age ≥ 61 years and masked HT independently correlated with CKD G3b/G4. In conclusion, ABPM revealed a high prevalence of non-/reverse-dippers and sustained/masked HT in Korean CKD patients. Clinicians should try to obtain a CKD patient's ABPM, especially among those who are older or who have advanced CKD as well as those with abnormal Ca × P product, iPTH, and albumin.

Original languageEnglish
Pages (from-to)772-781
Number of pages10
JournalJournal of Korean Medical Science
Volume32
Issue number5
DOIs
Publication statusPublished - 2017 May 1
Externally publishedYes

Fingerprint

Chronic Renal Insufficiency
Blood Pressure
Ambulatory Blood Pressure Monitoring
Masked Hypertension
White Coat Hypertension
Parathyroid Hormone
Albumins
Blood Pressure Monitors
Hypertension
Korea
Disease Progression

Keywords

  • Ambulatory blood pressure monitoring
  • Blood pressure
  • Chronic kidney disease
  • Hypertension
  • Masked hypertension
  • White-coat hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Discrepancies in clinic and ambulatory blood pressure in korean chronic kidney disease patients. / Oh, Yun Kyu; Chin, Ho Jun; Ahn, Shin Young; An, Jung Nam; Lee, Jung Pyo; Lim, Chun Soo; Oh, Kook Hwan.

In: Journal of Korean Medical Science, Vol. 32, No. 5, 01.05.2017, p. 772-781.

Research output: Contribution to journalArticle

Oh, Yun Kyu ; Chin, Ho Jun ; Ahn, Shin Young ; An, Jung Nam ; Lee, Jung Pyo ; Lim, Chun Soo ; Oh, Kook Hwan. / Discrepancies in clinic and ambulatory blood pressure in korean chronic kidney disease patients. In: Journal of Korean Medical Science. 2017 ; Vol. 32, No. 5. pp. 772-781.
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abstract = "Blood pressure (BP) control is considered the most important treatment for preventing chronic kidney disease (CKD) progression and associated cardiovascular complications. However, clinic BP is insufficient to diagnose hypertension (HT) and to monitor overall BP control because it does not correlate well with ambulatory blood pressure monitoring (ABPM). We enrolled 387 hypertensive CKD patients (stages G1-G4, 58.4{\%} male with median age 61 years) from 3 hospitals in Korea. HT of clinic BP and ABPM was classified as ≥ 140/90 and ≥ 130/80 mmHg, respectively. Clinic BP control rate was 60.2{\%}. The median 24-hour systolic blood pressures (SBPs) of CKD G3b and CKD G4 were significantly higher than those of CKD G1-2 and CKD G3a. However, the median 24-hour SBPs were not different between CKD G1-2 and CKD G3a or between CKD G3b and CKD G4. Of all patients, 5.7{\%}, 38.0{\%}. 42.3{\%}, and 14.0{\%} were extreme-dippers, dippers, non-dippers, and reverse-dippers, respectively. Non-/reverse-dippers independently correlated with higher Ca × P product, higher intact parathyroid hormone (iPTH), and lower albumin. Normal BP was 33.3{\%}, and sustained, masked, and white-coat HT were 29.7{\%}, 26.9{\%}, and 10.1{\%}, respectively. White-coat HT independently correlated with age ≥ 61 years and masked HT independently correlated with CKD G3b/G4. In conclusion, ABPM revealed a high prevalence of non-/reverse-dippers and sustained/masked HT in Korean CKD patients. Clinicians should try to obtain a CKD patient's ABPM, especially among those who are older or who have advanced CKD as well as those with abnormal Ca × P product, iPTH, and albumin.",
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AU - Lim, Chun Soo

AU - Oh, Kook Hwan

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AB - Blood pressure (BP) control is considered the most important treatment for preventing chronic kidney disease (CKD) progression and associated cardiovascular complications. However, clinic BP is insufficient to diagnose hypertension (HT) and to monitor overall BP control because it does not correlate well with ambulatory blood pressure monitoring (ABPM). We enrolled 387 hypertensive CKD patients (stages G1-G4, 58.4% male with median age 61 years) from 3 hospitals in Korea. HT of clinic BP and ABPM was classified as ≥ 140/90 and ≥ 130/80 mmHg, respectively. Clinic BP control rate was 60.2%. The median 24-hour systolic blood pressures (SBPs) of CKD G3b and CKD G4 were significantly higher than those of CKD G1-2 and CKD G3a. However, the median 24-hour SBPs were not different between CKD G1-2 and CKD G3a or between CKD G3b and CKD G4. Of all patients, 5.7%, 38.0%. 42.3%, and 14.0% were extreme-dippers, dippers, non-dippers, and reverse-dippers, respectively. Non-/reverse-dippers independently correlated with higher Ca × P product, higher intact parathyroid hormone (iPTH), and lower albumin. Normal BP was 33.3%, and sustained, masked, and white-coat HT were 29.7%, 26.9%, and 10.1%, respectively. White-coat HT independently correlated with age ≥ 61 years and masked HT independently correlated with CKD G3b/G4. In conclusion, ABPM revealed a high prevalence of non-/reverse-dippers and sustained/masked HT in Korean CKD patients. Clinicians should try to obtain a CKD patient's ABPM, especially among those who are older or who have advanced CKD as well as those with abnormal Ca × P product, iPTH, and albumin.

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