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Role and prognostic value of individual ambulatory blood pressure components in chronic kidney disease

Journal of Human Hypertension volume 32, pages 625–632 (2018)Cite this article

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Abstract

Hypertension is a key risk factor for chronic kidney disease (CKD), but can also be a detrimental consequence of established CKD. Unsurprisingly, the majority of subjects with abnormal creatinine in the general population are also hypertensive, with a huge toll on national health care systems worldwide due to a staggering increase in the risk of cardiovascular complications and end-stage renal disease requiring renal replacement therapy. In this setting, a comprehensive and careful assessment of the whole 24-h blood pressure (BP) profile could be of paramount importance in ensuring a timely diagnosis of hypertension and an optimal therapeutic control. Hence, ambulatory BP monitoring (ABPM) has the potential to become the preferred method for optimal clinical management of CKD patients. ABPM might better define the relationship between BP, target organ damage (TOD), and clinical outcomes. Current evidence suggests that specific day–night BP components, along with average BP values, may have clinical relevance in such patients, despite the suboptimal statistical power of available studies and inconsistencies on the prognostic value of individual BP components. The main aim of our review is to scrutinize the evidence for the usage of ABPM in CKD patients, including the relationship between ambulatory BP recordings and cardiovascular events, and the distinctive features of ABPM in these subjects.

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Author information

Authors and Affiliations

  1. Department of Cardiology and Cardiovascular Pathophysiology, Hospital and University of Perugia, Perugia, Italy

    Fabio Angeli

  2. Department of Renal Medicine, Royal Cornwall Hospitals, NHS Trust, Truro, United Kingdom

    Giorgio Gentile

  3. Department of Medicine, University of Perugia, Perugia, Italy

    Monica Trapasso & Gianpaolo Reboldi

  4. Fondazione Umbra Cuore ed Ipertensione – AUCI ONLUS, Perugia, Italy

    Paolo Verdecchia

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  1. Fabio Angeli
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  2. Giorgio Gentile
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  3. Monica Trapasso
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  4. Paolo Verdecchia
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  5. Gianpaolo Reboldi
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Correspondence to Gianpaolo Reboldi.

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Angeli, F., Gentile, G., Trapasso, M. et al. Role and prognostic value of individual ambulatory blood pressure components in chronic kidney disease. J Hum Hypertens 32, 625–632 (2018). https://doi.org/10.1038/s41371-018-0081-y

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