Ambulatory vs Office Blood Pressure Monitoring in Renal Transplant Recipients

Hypertension is common following renal transplantation and has adverse effects on cardiovascular and graft health. Ambulatory blood pressure monitoring ( ABPM ) is better at overall blood pressure ( BP ) assessment and is necessary to diagnose nocturnal hypertension, which is also implicated in poor outcomes. The authors performed a retrospective analysis of 98 renal transplant recipients ( RTR s) and compared office BP and ambulatory BP recordings. ABPM revealed discordance between office BP and ambulatory BP in 61% of patients, with 3% caused by white‐coat and 58% caused by masked hypertension (of which 33% were caused by isolated nocturnal hypertension). Overall, mean systolic BP was 3.6 mm Hg (0.5–6.5) and diastolic BP was 7.5 mm Hg (5.7–9.3) higher via ambulatory BP than office BP . This was independent of estimated glomerular filtration rate, proteinuria, transplant time/type, and comorbidities. A total of 42% of patients had their management changed after results from ABPM . ABPM should be routinely offered as part of hypertension management in RTR s.