Open AccessTHE PARTICULARITIES OF ABPM PARAMETERS IN HYPERTENSIVE PATIENTS WITH NON-DIALYSIS CKD
Author(s) -
Alexandru Mincă,
Mihai Comsa,
Maria Mirabela Manea,
Mihaela Tănăsescu,
Dorin Dragoș,
Mircea Penescu,
Dorin Ionescu
Publication year - 2017
Publication title -
romanian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2069-606X
pISSN - 1220-5478
DOI - 10.37897/rmj.2017.4.3
Subject(s) - medicine , ambulatory blood pressure , arterial stiffness , renal function , albuminuria , kidney disease , cardiology , blood pressure , population , dialysis , intensive care medicine , environmental health
Chronic kidney disease (CKD) affects approximately two million people (in a population of 20 million) in Romania. Hypertension is often associated with CKD and both (hypertension and CKD) are risk factors for cardiovascular (CV) events. Ambulatory blood pressure monitoring (ABPM) is increasingly used all around the world for the diagnosis and monitoring of BP (blood pressure) because it is proven that the ABPM is superior to office BP measurements in evaluating patients with hypertension, with or without CKD. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR). Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). It has prognostic value for cardiac death and stroke and several studies have showed that is negatively related to eGFR and is positively related to albuminuria. Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function. These facts suggest that ABPM offers multiple useful data with impact, not only in future CV and renal outcomes assessment, but also in the treatment and management of hypertensive patients with CKD.