Home blood pressure monitoring in blood pressure control among haemodialysis patients: an open randomized clinical trial

Background. It is not known if the adjustment of antihypertensive therapy based on home blood pressure monitoring (HBPM) can improve blood pressure (BP) control among haemodialysis patients. Methods. This is an open randomized clinical trial. Hypertensive patients on haemodialysis were randomized to...

Full description

Saved in:
Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2009-12, Vol.24 (12), p.3805-3811
Main Authors: da Silva, Giovanio Vieira, de Barros, Silvana, Abensur, Henry, Ortega, Katia Coelho, Mion, Décio
Format: Article
Language:English
Subjects:
ambulatory blood pressure monitoring
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antihypertensive Agents - therapeutic use
Biological and medical sciences
Blood Pressure Monitoring, Ambulatory
Cardiovascular system
Emergency and intensive care: renal failure. Dialysis management
Female
haemodialysis
home blood pressure monitoring
Humans
hypertension
Hypertension - diagnosis
Hypertension - drug therapy
Intensive care medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Renal Dialysis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background. It is not known if the adjustment of antihypertensive therapy based on home blood pressure monitoring (HBPM) can improve blood pressure (BP) control among haemodialysis patients. Methods. This is an open randomized clinical trial. Hypertensive patients on haemodialysis were randomized to have the antihypertensive therapy adjusted based on predialysis BP measurements or HBPM. Before and after 6 months of follow-up, patients were submitted to ambulatory blood pressure monitoring (ABPM) for 24 h, HBPM during 1 week and echocardiogram. Results. A total of 34 and 31 patients completed the study in the HBPM and predialysis BP groups, respectively. At the end of study, the systolic (SBP) and diastolic (DBP) blood pressure during the interdialytic period measured by ABPM were significantly lower in the HBPM group in relation to the predialysis BP group (mean 24-h BP: 135 ± 12 mmHg/76 ± 7 mmHg versus 147 ± 15 mmHg/79 ± 8 mmHg; P < 0.05). In the HBPM analysis, the HBPM group showed a significant reduction only in SBP compared to the predialysis BP group (weekly mean: 144 ± 21 mmHg versus 154 ± 22 mmHg; P < 0.05). There were no differences between the HBPM and predialysis BP groups in relation to the left ventricular mass index at the end of the study (108 ± 35 g/m2 versus 110 ± 33 g/m2; P > 0.05). Conclusions. Decision making based on HBPM among haemodialysis patients has led to a better BP control during the interdialytic period in comparison with predialysis BP measurements. HBPM may be a useful adjuvant instrument for blood pressure control among haemodialysis patients.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfp332