Blood Pressure Measurement and Left Ventricular Mass Index in Hemodialysis Patients: Comparison of Several Methods

Abstract

Introduction. Systemic arterial hypertension is prevalent in end-stage renal disease and is closely associated with left ventricular hypertrophy (LVH). Blood pressure (BP) behavior is unique in this population, and it is not clear which BP measurement should be used for treatment guidance. We aimed to evaluate the association of several methods of BP measurement with left ventricular mass index (LVMI) as hypertensive end-organ damage.

Materials and Methods. Patients on maintenance hemodialysis, 3 or 4 times per week for at least 3 months, were enrolled. We compared the diagnostic value of 6 different methods of BP measurement, including predialysis, postdialysis, interdialysis, and standard BP measurements as well as ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring, based on LVMI as the gold standard.

Results. Twenty patients, including 9 women and 11 men were enrolled. Ten patients (50%) had LVH and the others had normal LVMI (LVMI > 100 g/m² for women and > 131 100 g/m² for men). Only predialysis and postdialysis systolic BP values were significantly associated with LVMI (P = .02 and P = .02, respectively).

Conclusions. Predialysis and postdialysis systolic BP values maybe reliable for detecting hypertension in hemodialysis patients, although according to previous data, the importance of self and ambulatory BP monitoring could not be overlooked.