Prognostic Significance of ABPM in Comparison to Clinical Blood Pressure Monitoring and their Association with Various Risk Factors Involved in CKD Predisposition in North Indian Patients
Introduction: Ambulatory Blood Pressure Monitoring (ABPM) has been found to be a more reliable method for diagnosing Hypertension (HTN) and stratifying cardiovascular risk than Continuous Blood Pressure (CBP) monitoring. Aim: To evaluate prognostic significance of ABPM in comparison to clinical...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15715/51001_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU_KM)_PB(AG_KM)_PN(KM).pdf |
| Summary: | Introduction: Ambulatory Blood Pressure Monitoring (ABPM)
has been found to be a more reliable method for diagnosing
Hypertension (HTN) and stratifying cardiovascular risk than
Continuous Blood Pressure (CBP) monitoring.
Aim: To evaluate prognostic significance of ABPM in comparison
to clinical Blood Pressure (BP) Monitoring and their association
with various risk factors involved in Chronic Kidney Disease
(CKD) patients.
Materials and Methods: This was a prospective study done
in Era’s Lucknow Medical College and Hospital, Lucknow,
Uttar Pradesh, India. Routine laboratory tests were conducted
for all patients. Casual Blood Pressure (BP) was obtained by
a trained staff through a digital BP monitor (CITIZEN-CH-432)
and Meditech ABPM-05 device was used for ABPM. Pearson's
correlation method was used to analyse the relationship
between the two continuous variables.
Results: Present study included 400 patients of which 225
(56.25%) were male subjects, and mean age was 62 (Range21-76) years. Of the study population, 90 (22.5%) were CKD
G1-2, 79 (19.75%) were CKD G3a, 96 (24%) were CKD G3b,
and 135 (33.75%) were CKD G4. Among all the patients
included in the study, the most common was normal BP
(33.75%), sustained HTN (26.25%), White Coat Hypertension
(WCH) (6.5%), and masked HTN (33.5%). When multiple
logistic regression analyses were done, estimated Glomerular
Filtration Rate (eGFR), and BP data, night-time Systolic Blood
Pressure (SBP) (OR, 1.043; 95% CI, 1.025-1.067; p<0.001),
and night-time Diastolic Blood Pressure (DBP) was found
(OR, 1.050; 95% CI, 1.013-1.075) to have an independent
association with non/reverse-dippers.
Conclusion: The ABPM has more prognostic significance when
compared to office BP measurements in all kind of normotensive,
hypertensive and CKD patients at all stages. ABPM measurements
are often abnormal in CKD, with CKD patients frequently showing
an altered circadian rhythm with an increased rate of non dipping
and reverse dipping |
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| ISSN: | 2249-782X 0973-709X |