The relationship between blood pressure parameters and chronic heart failure in patients on hemodialysis


DOI: https://dx.doi.org/10.18565/nephrology.2018.1.20-25

E.O. Borodulina, A.M. Shutov

1 Medical Private Institution of Further Professional Education "Nefrosovet", Department of Nephrology and Hemodialysis; Kirov, Russia; 2 FSBEI HE "Ulyanovsk State University", Medical Faculty; Ulyanovsk, Russia
Purpose. The study was to investigate the relationship between the blood pressure (BP) parameters and chronic heart failure (CHF) in patients on programmed hemodialysis (HD).
Material and Methods. A total of 62 patients (32 women, 30 men, mean age 52.9±13.2 years), who had been treated with HD for at least 1 year, were examined. CHF was diagnosed in 25 patients. Predialysis systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse blood pressure (PBP), postdialysis SBP, DBP, PBP, and variability of blood pressure parameters were evaluated. Patients underwent 24-hour BP monitoring starting in the morning of the following HD day. From the same day, patients independently measured blood pressure in the morning and evening at home for 30 days. The variability of the blood pressure parameters obtained during measuring blood pressure before and after HD at home and during 24-hour BP monitoring was evaluated.
Results. 25 (40.3%) patients had arterial hypertension. Left ventricular hypertrophy was diagnosed in 41 (66.1%) patients. The average DBP, according to the results of self-measurement of blood pressure, was significantly lower in patients with CHF. Multivariate regression analysis showed that the average morning and evening DBP were negatively independently associated with CHF (Beta=-0.62, P=0.001 and Beta =-0.56, P=0.003, respectively). The relative risk of CHF with DBP<80 mmHg was 1.16 (95% CI, 1.06–1.27) for the average morning DBP and 1.16 (95% CI, 1.05–1.28) for the mean DBP, calculated from the results of self-measurement of blood pressure.
Conclusions. The average morning and evening DBP, calculated from the results of self-measurement of blood pressure at home for 30 days, have a stronger independent reverse relationship with CHF than the parameters of 24-hour BP monitoring, performed the day after the HD.
Keywords: arterial hypertension, blood pressure variability, hemodialysis, left ventricular hypertrophy, chronic heart failure

About the Autors


Information about the authors:
Borodulina E.O. – Nephrologist at the Department of Nephrology and Hemodialysis of the Medical Private Institution of Further Professional Education "Nefrosovet"; Kirov, Russia. E-mail: parizhanskay@yandex.ru
Shutov A.M. – Doctor of Medical Sciences, Professor, Head of the Department of Therapy and Occupational Diseases of the Medical Faculty FSBEI HE UlSU; Ulyanovsk, Russia. E-mail: amshu@mail.ru


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