Premium
Hypertension and left ventricular mass index (L.VMI) in patients on regular hemodialysis (RDT)
Author(s) -
Papadimitriou M.,
Pashalidis K.,
Vakianis P.,
Diamantopoulou D.,
Interbalkan Chr. Raidis.
Publication year - 2005
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2005.1121as.x
Subject(s) - medicine , cardiology , hemodialysis , left ventricular hypertrophy , calcium channel blocker , dialysis , end stage renal disease , urology , blood pressure
It has already been established that the most frequent cause of death in patients (pts) on RDT is cardiovascular. In fact, more than half of the deaths are related to cardiovascular disease. The purpose of the study was to investigate in pts with end‐stage renal disease the impact of hypertension on LVMI, a parameter which has already been found increased in early renal disease. Two hundred ninety seven pts (174 male) were included in this study with a mean follow‐up of 3 years. Sixty‐ six percent of these pts (first group) were on antihypertensive agents with one or more (in combination up to 4) drugs. Analytically, as monotherapy or in combination, 29.7% of the pts were taking a β‐blocker, 25.7% an a MEA, 8.9% an angiotensin receptor antagonist, 51.5% a calcium channel blocker, 11.9% a centrally active agent and 1% an α‐blocker. Forty‐four percent of the pts (secound group) were not on antihypertensive therapy at any time. Left atrial dimension (LAD) less than 3 cm, left venticular volume (LVV) less than 150 ml, and left ventricular mass index (LVMI) less than 130 gm/m 2 for male and less than 100 gm/m 2 for female pts were considered as normal values. The above parameters were measured using 3D Gen. Electric echocardiograph (Model VIVIO 3). There was no difference between the 2 groups in sex, age, EPO administration, high or low flux filter dialysis, and remaining urine volume. On the other hand, there was a statistically significant correlation between the systolic blood pressure (BP) and the blood urea before dialysis (p = 0.015) and the increase of body weight in between dialysis (p = 0.03). Finally, there was no statistical difference between the 2 groups in LAD and LVV, but 37.8% of the hypertensives had higher LVMI as compared with 23.2% of the normotensives (x 2 = 3.028, p < 0.05). In conclusion, mainly the pts who had no compliance with their diet needed antihypertensive treatment. On the other hand, despite the clinically efficient antihypertensive therapy, the LVMI remained high in this group, and possibly this is one of the reasons of higher morbidity and mortality in this category of patients as it has already been shown in pts before starting haemodialysis.