The usefulness of automatic office blood pressure measurement in comparison with 44-hour ambulatory blood pressure monitoring in hemodialyzed patients - preliminary results.

Abstract Background Arterial hypertension occurs in nearly 82-89% of patients who undergo hemodialysis (HD) due to renal failure. In this group, hypertension is satisfactorily controlled in only 30% of patients. The lack of satisfactory blood pressure control is associated with very high cardiovascular morbidity and mortality. However, 44-hour ambulatory blood pressure monitoring (ABPM) remains a gold standard in this group, in the recent years automated office blood pressure monitoring (AOBP) has been proposed to increase the accuracy of office blood pressure (OBP) readings. Purpose This study aimed to compare 44-hour ABPM with postdialytic and predialytic AOBPM in HD patients on stable hemodialysis prescription. Methods We examined 41 patients (mean age 64.61± 13.78, 53.7% male, 51.2% permcath), who were undergoing a middle of a week dialyses in our HD-center. In each patient AOBPM measurement was be performed after dialysis and then for 44 hours (interdialysis) an ABPM monitor was worn. After the ABPM was completed, the pressure was measured again by the AOBPM method. Results We found no significant statistical difference in AOBPM measurement values post and pre dialyses. Mean systolic blood pressure (SBP) post dialyses was 138,8± 26 mmHg vs pre dialyses SBP 137 ± 22 mmHg, p=. Mean diastolic blood pressure (DBP) post dialyses was 78.96 ± 11.67 mmHg vs 78.28± 10.99 mmHg. Moreover, we found no significant statistical difference in AOBPM measurement values post and pre dialyses in comparison with ABPM mean SBP and mean DBP. Conclusions Performing AOBPM before or after dialysis can approximate mean SBP and DBP values from 44-hour ABPM. Therefore, use ABOMP could increase the availability of effective and reliable method of blood pressure measurement, reduce time of examination and improve blood pressure control in hemodialysis patients.