Relationship Between Within-Visit Blood Pressure Variability and Kidney Function in Patients with Arterial Hypertension

Abstract

The main purpose of this study was to investigate the features of within-visit blood pressure variability (BPV) in patients with arterial hypertension (AH) and to assess the relationship of those features to impaired renal filtration. Material and Methods: The study included 120 patients with AH Stages I and II (ESH/ESC, 2013): 58(48.3%) men and 62(51.7%) women aged from 22 to 73 years (mean age 58.7±15 years). Average duration of AH was 15.0±6.7 years. BP was measured three times during visit. BP was measured three times at 2-minute intervals during one visit. Within-visit BPV was evaluated by the presence of an absolute difference (AD) between any two readings of three SBP measurements of more than 5mmHg. All patients underwent a comprehensive examination, which included blood and urine tests, kidney ultrasound, assessment of blood levels of creatinine and TnT, and calculation of GFR. Results: Depending on the response of BP to repeated measurements, three types of BPV were identified. A prognostically unfavorable type of BPV, which is characterized by SBP-AD >5mmHg between the third and first measurements, was identified. Patients of this group had the lowest eGFR value that indicates more pronounced renal damage, and, as a consequence, worse prognosis. Also in these patients, there was an increase in TnT level, which is a predictor of the development of adverse cardiovascular complications.

Keywords

• arterial hypertension
• blood pressure variability
• glomerular filtration rate
• chronic kidney disease