How well is hypertension controlled in CAPD patients?

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.