Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology
Whereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is att...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/12/2961 |
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| author | Panagiotis I. Georgianos Vasilios Vaios Vasiliki Sgouropoulou Theodoros Eleftheriadis Dimitrios G. Tsalikakis Vassilios Liakopoulos |
| author_facet | Panagiotis I. Georgianos Vasilios Vaios Vasiliki Sgouropoulou Theodoros Eleftheriadis Dimitrios G. Tsalikakis Vassilios Liakopoulos |
| author_sort | Panagiotis I. Georgianos |
| collection | DOAJ |
| description | Whereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is attributable to particular difficulties in the accurate diagnosis of hypertension. The reverse epidemiology of hypertension in dialysis patients is based on evidence from large cohort studies showing that routine predialysis or postdialysis BP measurements exhibit a U-shaped or J-shaped association with cardiovascular or all-cause mortality. However, substantial evidence supports the notion that home or ambulatory BP measurements are superior to dialysis-unit BP recordings in diagnosing hypertension, in detecting evidence of target-organ damage and in prognosticating the all-cause death risk. In the first part of this article, we explore the accuracy of different methods of BP measurement in diagnosing hypertension among patients on dialysis. In the second part, we describe how the epidemiology of hypertension is modified when the assessment of BP is based on dialysis-unit versus home or ambulatory recordings. |
| first_indexed | 2024-03-09T17:08:31Z |
| format | Article |
| id | doaj.art-9b9f9ae864504b76a47aadc4079518a9 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T17:08:31Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-9b9f9ae864504b76a47aadc4079518a92023-11-24T14:16:15ZengMDPI AGDiagnostics2075-44182022-11-011212296110.3390/diagnostics12122961Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of EpidemiologyPanagiotis I. Georgianos0Vasilios Vaios1Vasiliki Sgouropoulou2Theodoros Eleftheriadis3Dimitrios G. Tsalikakis4Vassilios Liakopoulos5Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceSection of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceSection of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceDepartment of Nephrology, School of Medicine, University of Thessaly, 41222 Larissa, GreeceDepartment of Electrical and Computer Engineering, University of Western Macedonia, 50100 Kozani, GreeceSection of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceWhereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is attributable to particular difficulties in the accurate diagnosis of hypertension. The reverse epidemiology of hypertension in dialysis patients is based on evidence from large cohort studies showing that routine predialysis or postdialysis BP measurements exhibit a U-shaped or J-shaped association with cardiovascular or all-cause mortality. However, substantial evidence supports the notion that home or ambulatory BP measurements are superior to dialysis-unit BP recordings in diagnosing hypertension, in detecting evidence of target-organ damage and in prognosticating the all-cause death risk. In the first part of this article, we explore the accuracy of different methods of BP measurement in diagnosing hypertension among patients on dialysis. In the second part, we describe how the epidemiology of hypertension is modified when the assessment of BP is based on dialysis-unit versus home or ambulatory recordings.https://www.mdpi.com/2075-4418/12/12/2961hypertensiondialysisdiagnosisepidemiologyhome BP monitoringambulatory BP monitoring |
| spellingShingle | Panagiotis I. Georgianos Vasilios Vaios Vasiliki Sgouropoulou Theodoros Eleftheriadis Dimitrios G. Tsalikakis Vassilios Liakopoulos Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology Diagnostics hypertension dialysis diagnosis epidemiology home BP monitoring ambulatory BP monitoring |
| title | Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology |
| title_full | Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology |
| title_fullStr | Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology |
| title_full_unstemmed | Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology |
| title_short | Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology |
| title_sort | hypertension in dialysis patients diagnostic approaches and evaluation of epidemiology |
| topic | hypertension dialysis diagnosis epidemiology home BP monitoring ambulatory BP monitoring |
| url | https://www.mdpi.com/2075-4418/12/12/2961 |
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