Twenty-four-hour blood pressure and heart rate patterns in chronic hemodialysis patients

To test the assumption that the previously reported abnormal 24-hour blood pressure (BP) variations in hemodialysis (HD) patients might be due to associated complications of chronic renal failure, we recorded the 24-hour noninvasive BP and heart rate (HR) patterns in 14 carefully selected chronic HD patients. No of the patients suffered from orthostatic hypotension, and all were free of any previously reported associated condition known to affect the 24-hour BP profiles. The BP and HR profiles were quantitatively analyzed using the periodogram method. The results were compared those from 14 controls matched for age, sex, and casual BP. No difference could be found between the HD patients and the controls, either in the absolute and relative amplitudes of the 24-hour systolic BP and diastolic BP variations or in the timings and levels of their respective acrophases and nadirs (except for the timings of the second systolic BP and diastolic BP acrophases; P < 0.05). The absolute levels of the HR acrophases and nadirs were higher in the HD patients than in the controls (P < 0.05 and P < 0.01, respectively), while both the absolute and relative amplitudes of the 24-hour HR profiles and the relative values and timings of the HR acrophases and nadirs were similar in both groups. Consequently, the 24-hour HR pattern was similar in the HD patients than in the controls, except that the entire profile was shifted upward.(ABSTRACT TRUNCATED AT 250 WORDS)