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Association between routine and standardized blood pressure measurements and left ventricular hypertrophy among

Jaspreet Khangura1, Bruce F Culleton, Braden J Manns

  • 1Department of Medicine, University of British Columbia, Vancouver, Canada.

BMC Nephrology
|June 26, 2010
PubMed

Insights

Standardized blood pressure (BP) measurements strongly predict left ventricular (LV) hypertrophy in hemodialysis patients. Pre-dialysis BP is a weak predictor, suggesting guidelines may need updating.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Management

Background:

  • Left ventricular (LV) hypertrophy is prevalent in hemodialysis patients.
  • The relationship between blood pressure (BP) and LV hypertrophy is known, but the optimal BP measurement method remains unclear.

Purpose of the Study:

  • To assess agreement between various BP measurement methods.
  • To identify the strongest BP measurement correlate of LV hypertrophy in hemodialysis patients.

Main Methods:

  • Post-hoc analysis of a randomized controlled trial data.
  • Evaluated seven BP measurement methods including standardized, pre-dialysis, post-dialysis, intra-dialytic, and cumulative readings.
  • Assessed agreement using Lin's CCC and Bland Altman; determined predictive power for LV hypertrophy using ROC curves and AUC.

Main Results:

  • Agreement varied significantly across BP measurement methods (CCC 0.35-0.94).
  • Pre-dialysis BP measurements were the weakest predictors of LV hypertrophy.
  • Standardized, post-dialytic, and inter-dialytic measurements showed strong predictive power (AUC 0.79-0.80).

Conclusions:

  • A single standardized BP measurement effectively predicts LV hypertrophy, matching the performance of cumulative measurements.
  • Pre-dialysis BP measurements are poor predictors of LV hypertrophy.
  • Current guidelines recommending pre-dialysis BP measurements warrant re-evaluation.
Abstract

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