[Day-by-day variability of home blood pressure in patients with chronic kidney disease]
Related Experiment Video
Updated: Jul 2, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Tomonari Okada1, Toshiyuki Nakao, Hiroshi Matsumoto
1Department of Nephrology, Tokyo Medical University, Tokyo, Japan.
Insights
Home blood pressure (HBP) variability was higher in the evening, in female, and diabetic nephropathy patients with chronic kidney disease (CKD). This HBP variability did not correlate with estimated glomerular filtration rate (eGFR) decline over two years.
Area of Science:
- Nephrology and Hypertension Research
- Cardiovascular Disease Monitoring
Context:
- Chronic kidney disease (CKD) affects blood pressure (BP) regulation.
- Home blood pressure (HBP) monitoring provides insights into daily BP fluctuations.
- Understanding day-by-day BP variability is crucial for managing CKD patients.
Purpose:
- To investigate the characteristics of day-by-day home blood pressure (HBP) variability in patients with chronic kidney disease (CKD).
- To assess the association between HBP variability and the rate of estimated glomerular filtration rate (eGFR) decline over a two-year period.
Summary:
- Day-by-day variability of HBP, measured as coefficient of variation (CV), was analyzed in 368 CKD patients.
- Higher HBP variability was observed in the evening, in female patients, and in those with diabetic nephropathy (DN).
- No significant association was found between HBP variability and the decline in eGFR over two years.
Impact:
- Identifies specific patient subgroups (females, DN patients) with potentially greater HBP variability in CKD.
- Suggests that day-by-day HBP variability may not be a direct predictor of kidney function decline in CKD.
- Highlights the need for further research to determine the clinical significance of HBP variability in CKD management.
Purpose:
We examined the characteristics of the day-by-day variability of home blood pressure (HBP) in patients with chronic kidney disease (CKD).
Methods:
We obtained HBP recordings from 368 CKD patients (63+/-13 years, eGFR 34+/-23 mL/min/1.73 m2, males 253). The day-by-day variability of HBP was defined as the coefficient of variation (CV) values of BP measurements every morning after waking and every evening before sleeping on 7 consecutive days. In a portion of the patients, the CV values of HBP were collected every 6 months during a 2-year period and the association with a decline in GFR was examined.
Results:
CV values of morning/evening systolic BP (SBP) were 5.4+/-2.4%, 6.1+/-2.9 % (p<0.01). The CV values of morning SBP in females or patients with diabetic nephropathy (DN) were significantly greater than those in males or patients without DN, respectively (females 5.9+/-2.3%, males 5.2+/-2.4%, p< 0.01, DN 6.1+/-2.8 %, non DN 5.2+/-2.2 %, p<0.05). Multivariate linear regression analysis showed that female gender, DN, the number of antihypertensive drugs, higher heart rate and higher CV values of heart rate were associated with higher CV values of the morning SBP. CV values of the morning SBP showed no significant change during the 2-year period (0; 5.4+/-2.6%, 1 year; 5.3+/-2.9%, 2 years 5.6+/-3.1%, n=200). There was no significant difference in the change in eGFR between a group with high CV values (greater than 5 %) and a group with low CV values (lower than 5 %) during the 2-year period.
Conclusions:
In CKD patients, the day-by-day variability of HBP tended to be greater in the evening, in female and DN patients. There was no significant association between the day-by-day variability of HBP and decline rate in eGFR. Further studies are needed to clarify the clinical significance of the day-by-day variability of HBP in CKD patients.
Related Concept Videos
01:18Hypertension and Regulation of Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:25Chronic Kidney Disease I: Introduction
01:18Chronic Kidney Disease IV: Nursing Management
01:30Blood Pressure
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...