MONDAY, June 27 (HealthDay News) -- Blood pressure readings
logged over a 24-hour period on a portable home monitoring device
appear more effective than blood pressure readings taken in a
doctor's office for predicting whether patients with chronic kidney
disease will experience kidney failure or death.
That's the finding of an Italian study that included 436 chronic
kidney disease patients who were not on dialysis.
In the study, each patient's blood pressure was measured
multiple times while at a clinic over the course of two days. They
were also given an ambulatory blood pressure monitor that took
readings every 15 minutes during the day and every half hour at
night over a 24-hour period.
At-home blood pressure monitors are believed to help overcome
what's known as "white coat hypertension," in which a patient's
blood pressure spikes because of stress and anxiety when visiting a
physician's office. According to background information in the
article, chronic kidney disease patients are especially vulnerable
to this.
Prior research has also suggested that nighttime blood pressure
readings may be a better measure of a patient's actual blood
pressure status because readings are taken when the patient is at
rest and free of the physical and emotional stresses of everyday
life that can have an impact on readings.
During an average follow-up of 4.2 years, 86 patients developed
kidney failure and 69 died. There were also 63 non-fatal
cardiovascular events and 52 deaths caused by cardiovascular
problems.
Patients with the highest risk of kidney or cardiovascular
problems were those whose daytime systolic (top number) blood
pressure was 135 mm Hg or higher; those with high diastolic (bottom
number) readings; those with nighttime systolic readings of 124 mm
Hg or higher; and those with nighttime diastolic readings of 70 mm
Hg or higher. All these readings were provided by the ambulatory
device.
"In contrast, office [blood pressure] measurements ... did not predict cardiovascular or renal events," the researchers wrote.
The study appears in the June issue of the journal
Archives of Internal Medicine.
More information
The American Academy of Family Physicians has more about
chronic kidney disease.