MORIMOTO Satoshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Characteristics of visit-to-visit blood pressure variability in hemodialysis patients.
Journal Formal name：Hypertension research : official journal of the Japanese Society of Hypertension
Abbreviation：Hypertens Res
ISSN code：13484214/09169636
Domestic / ForeginForegin
Volume, Issue, Page 42(7),pp.1036-1048
Author and coauthor Amari Yoshifumi†, Morimoto Satoshi*, Iida Takeshi, Yurugi Takatomi, Oyama Yasuo, Aoyama Naoki, Nakajima Fumitaka, Shimizu Satoru, Ichihara Atsuhiro
Authorship 2nd author,Corresponding author
Publication date 2019/07
Summary Visit-to-visit blood pressure variability (VVBPV) is an independent risk factor for cardiovascular morbidity and mortality in the general population. Hemodialysis (HD) patients have a poor prognosis due to an increased prevalence of cardiovascular disease. Intradialytic hypotension is associated with excess mortality, but whether VVBPV influences mortality is still unclear in HD patients. The present study aimed to investigate the characteristics of VVBPV in these patients. A total of 324 maintenance HD patients, who could be followed for 60 months, were recruited. We used variation independent of the mean (VIM) in pre-dialysis systolic blood pressure (pre-VIM-SBP) as an index of VVBPV. We investigated (1) the reproducibility of pre-VIM-SBP, (2) the relationship between pre-VIM-SBP and background factors, and (3) the association between pre-VIM-SBP and mortality. Pre-VIM-SBP showed significant reproducibility [intraclass correlation, 0.45 (P < 0.001)]. Higher pre-VIM-SBP was associated with less physical activity and worse left ventricular diastolic function. Higher pre-VIM-SBP was associated with a higher rate of cardiovascular deaths independent of other factors. These data suggest that VVBPV in HD patients is reproducible and associated with various background factors. VVBPV is independently correlated with cardiovascular mortality (hazard ratio: 1.166, 95% confidence interval: 1.030-1.320, P = 0.015). Further studies are necessary to confirm the mechanism of increased VVBPV and to clarify whether reducing VVBPV will improve the prognosis for HD patients.
DOI 10.1038/s41440-019-0231-9
PMID 30770904