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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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24-h central pressure is a valuable predictor for left ventricular hypertrophy in non-dialysis patients with chronic

Cheng Chen1, Lingling Liu1, Sirui Liu1

  • 1Division of Nephrology, Department of Medicine, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|March 30, 2024
PubMed

Insights

Central systolic blood pressure (cSBP) better predicts left ventricular hypertrophy (LVH) in chronic kidney disease (CKD) patients than brachial blood pressure (BP). This finding highlights cSBP

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Existing research on 24-hour central and brachial blood pressure (BP) and left ventricular hypertrophy (LVH) has limitations in sample size and consistency.
  • The association between central and brachial BP and LVH has not been previously studied in patients with chronic kidney disease (CKD).
  • CKD is associated with increased cardiovascular risk, including LVH, making accurate BP assessment crucial.

Purpose of the Study:

  • To investigate the association between 24-hour central systolic blood pressure (cSBP) and 24-hour brachial systolic blood pressure (bSBP) with LVH in non-dialysis CKD patients.
  • To compare the efficacy of 24-h cSBP versus 24-h bSBP in identifying LVH in this population.

Main Methods:

  • A multicentre, cross-sectional study involving 2117 non-dialysis CKD patients.
  • 24-hour ambulatory BP monitoring using MobilO-Graph PWA for both brachial and central BP.
  • Echocardiography performed by trained cardiologists to assess LVH.

Main Results:

  • 24-hour cSBP showed a stronger association with left ventricular mass index and LVH than 24-h bSBP in univariate and multivariate analyses.
  • Multivariate net reclassification index (NRI) analysis indicated superior discriminatory power of 24-h cSBP over 24-h bSBP (NRI = 0.310, P < 0.001).
  • Concordant hypertension (both central and brachial elevated) was significantly associated with a higher prevalence of LVH compared to isolated brachial hypertension or normotension.

Conclusions:

  • 24-hour cSBP is more effective than 24-h bSBP in identifying LVH among non-dialysis CKD patients.
  • Central BP monitoring provides valuable insights into cardiovascular remodeling in CKD patients.
  • Targeting central hypertension may be crucial for preventing LVH in CKD.

Keywords:
24-h brachial pressure24-h central pressureChronic kidney diseaseLeft ventricular hypertrophy

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