Related Experiment Videos
How well is hypertension controlled in CAPD patients?
J S Cheigh1, D Serur, M Paguirigan
1Rogosin Institute, New York, New York.
Insights
Hypertension is often poorly controlled in continuous ambulatory peritoneal dialysis (CAPD) patients, especially those with diabetes. Ambulatory blood pressure monitoring helps guide therapy for better hypertension management in CAPD.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Management
Background:
- Hypertension is a common complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Effective blood pressure control is crucial for managing cardiovascular risk in CAPD patients.
Purpose of the Study:
- To assess the level of hypertension control in adult CAPD patients.
- To investigate the circadian rhythm of blood pressure in CAPD patients.
- To evaluate the effectiveness of ambulatory blood pressure monitoring in guiding antihypertensive therapy.
Main Methods:
- 31 hypertensive adult CAPD patients were monitored using noninvasive ambulatory blood pressure monitoring for 24 hours.
- Blood pressure readings were taken every 30-60 minutes, averaging 42 readings per patient.
- Antihypertensive medications were adjusted in 8 patients with poorly controlled hypertension, followed by repeat monitoring.
Main Results:
- Mean 24-hour blood pressure was 145.6/91.3 mm Hg, with 40.5% of systolic and 50.2% of diastolic readings exceeding recommended levels.
- Diabetic CAPD patients exhibited worse hypertension control.
- No significant differences in blood pressure, heart rate, or blood pressure load were observed between daytime and nighttime, indicating a lack of normal circadian rhythm.
Conclusions:
- Hypertension is suboptimally controlled in the majority of CAPD patients, with diabetic patients experiencing even poorer control.
- CAPD patients typically do not maintain a normal circadian blood pressure rhythm.
- Ambulatory blood pressure monitoring is a valuable tool for assessing and guiding the management of hypertension in CAPD patients.
Unlabelled:
To determine how well hypertension is controlled in continuous ambulatory peritoneal dialysis (CAPD) patients, we monitored the blood pressure of 31 hypertensive adult CAPD patients treated with antihypertensive agents. Blood pressure (BP) monitoring, using a noninvasive, ambulatory BP monitor, began in the morning and continued every 30-60 min for 24 h (mean 42 readings per patient). The mean BP of all patients over 24 h was 145.6/91.3 mm Hg. In these, 40.5% of systolic BP readings exceeded 150 mm Hg and 50.2% of diastolic readings exceeded 90 mm Hg, suggesting that hypertension was inadequately controlled for a considerable period of time. Diabetic patients had even worse control of BP. Mean BP, heart rates, and BP loads were not different, between daytime or nighttime. These findings suggest that CAPD patients do not preserve the normal circadian rhythm of BP and that their hypertension is not controlled any better during the night than during the day. We repeated BP monitoring after adjustment of antihypertensive medications in 8 patients who had poorly controlled hypertension. Systolic and diastolic BP loads in subsequent studies improved significantly from the first study.
In Conclusion:
hypertension is suboptimally controlled in most CAPD patients; diabetic patients fare even worse in the control of hypertension; most patients do not preserve the circadian rhythm of BP and there is no difference in the adequacy of hypertension control during the day or at night; assessment of hypertension with ambulatory BP monitoring helps guide therapy and control of hypertension.