Morning blood pressure is useful for detection of left ventricular hypertrophy in hemodialysis patients Clinical and Experimental Nephrology, 05/15/2012

Ago R et al. – Morning BP is useful for detecting left ventricular hypertrophy in hemodialysis patients. Monitoring of morning BP may be superior to measurements taken at other times for diagnosing hypertension.

• A total of 100 HD patients (mean age 63.8 years, 60 males) were studied.
• Left ventricular hypertrophy (LVH) was detected by echocardiography and BP monitored for 1 week at 20 different times in the morning and night, before and after dialysis.
• The authors also checked for masked HT, i.e., patients with weekly morning HT, but not pre-dialysis HT.

• Average BP for the week was 141.9 ±19.0/79.6 ± 10.6 mmHg, with 68 patients classified as hypertensive.
• Average morning BP was 144.6 ± 19.8/81.7 ± 11.3 mmHg, and 71 patients had weekly morning HT.
• In addition, 62 patients had LVH and 51 patients had relative morning HT.
• Multiple logistic analyses showed that LVH was associated with weekly morning HT, morning HT on HD and non-HD days, average HT, and relative morning HT.
• However, evening, pre-dialysis, and post-dialysis HT showed no association with LVH.
• Masked HT was found in 20 % of patients.
• If HT had been diagnosed using only pre-dialysis BP, 20 of the 71 patients with weekly morning HT would not have been detected.