Clinical significance of blood pressure variability in chronic kidney disease and hemodialytic patients_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Jiamin , YU Shikai , ZHANG Yi ,  XU Yawei

Department of Cardiology, Shanghai Tenth People’s Hospital of Tongji University School of Medicine, Shanghai, 200072, P.R.China;

Corresponding author：

XU Yawei, Email: xuyawei@tongji.edu.cn

Keywords：

Blood pressure variability; Chronic kidney disease and hemodialysis; Target organ damage; Cardiovascular event; All-cause mortality

DOI：

10.7507/1672-2531.201808069

Video：

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Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.

Citation： TANG Jiamin, YU Shikai, ZHANG Yi, XU Yawei. Clinical significance of blood pressure variability in chronic kidney disease and hemodialytic patients. Chinese Journal of Evidence-Based Medicine, 2018, 18(10): 1018-1021. doi: 10.7507/1672-2531.201808069 Copy

1.	Parati G, Ochoa JE, Bilo G, et al. Hypertension in chronic kidney disease part 2: role of ambulatory and home blood pressure monitoring for assessing alterations in blood pressure variability and blood pressure profiles. Hypertension, 2016, 67(6): 1102-1110.
2.	Flythe JE, Inrig JK, Shafi T, et al. Association of intradialytic blood pressure variability with increased all-cause and cardiovascular mortality in patients treated with long-term hemodialysis. Am J Kidney Dis, 2013, 61(6): 966-974.
3.	Rossignol P, Cridlig J, Lehert P, et al. Visit-to-visit blood pressure variability is a strong predictor of cardiovascular events in hemodialysis: insights from FOSIDIAL. Hypertension, 2012, 60(2): 339-346.
4.	赵景新, 张永艳, 陶楠楠, 等. 维持性血液透析患者血压变异性与左心室肥厚的相关性分析. 医学综述, 2017, 23(7): 1450-1453.
5.	陈爱群, 孙颖, 王海涛, 等. 血液透析中血压变异性及影响因素的初步探讨. 中华肾脏病杂志, 2013, 29(12): 888-892.
6.	Yano Y, Fujimoto S, Kramer H, et al. Long-term blood pressure variability, new-onset diabetes mellitus, and new-onset chronic kidney disease in the Japanese general population. Hypertension, 2015, 66(1): 30-36.
7.	Xia Y, Liu X, Wu D, et al. Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population. Sci Rep, 2017, 7(1): 8394.
8.	Mena LJ, Felix VG, Melgarejo JD, et al. 24-Hour blood pressure variability assessed by average real variability: a systematic review and meta-analysis. J Am Heart Assoc, 2017, 6(10): 1076-1085.
9.	Tanner RM, Shimbo D, Dreisbach AW, et al. Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study. BMC Nephrol, 2015, 16: 84.
10.	Flythe JE, Brunelli SM. Blood pressure variability among chronic dialysis patients: recent advances in knowledge. Curr Opin Nephrol Hypertens, 2015, 24(2): 163-169.
11.	Chi C, Yu SK, Auckle R, et al. Association of left ventricular structural and functional abnormalities with aortic and brachial blood pressure variability in hypertensive patients: the SAFAR study. J Hum Hypertens, 2017, 31(10): 633-639.
12.	Wei FF, Li Y, Zhang L, et al. Beat-to-beat, reading-to-reading, and day-to-day blood pressure variability in relation to organ damage in untreated Chinese. Hypertension, 2014, 63(4): 790-706.
13.	Gosmanova EO, Mikkelsen MK, Molnar MZ, et al. Association of systolic blood pressure variability with mortality, coronary heart disease, stroke, and renal disease. J Am Coll Cardiol, 2016, 68(13): 1375-1386.
14.	Omboni S, Posokhov IN, Rogoza AN. Relationships between 24-h blood pressure variability and 24-h central arterial pressure, pulse wave velocity and augmentation index in hypertensive patients. Hypertens Res, 2017, 40(4): 385-391.
15.	Chen Y, Xiong H, Wu D, et al. Relationship of short-term blood pressure variability with carotid intima-media thickness in hypertensive patients. Biomed Eng Online, 2015, 14: 71.
16.	Yokota K, Fukuda M, Matsui Y, et al. Impact of visit-to-visit variability of blood pressure on deterioration of renal function in patients with non-diabetic chronic kidney disease. Hypertens Res, 2013, 36(2): 151-157.
17.	Gorostidi M, Sarafidis P, Sierra AL, et al. 3D.02: blood pressure variability increases with advancing chronic kidney disease stage. a cross-sectional analysis of 14,382 hypertensive patients from spain. J Hypertens, 2015, 33(23): e40.
18.	谷立杰, 张郁苒, 袁伟杰, 等. 维持性血液透析患者透析中血压变异性的相关因素及其对预后的影响. 中华内科杂志, 2013, 52(6): 453-458.
19.	Mallamaci F, Minutolo R, Leonardis D, et al. Long-term visit-to-visit office blood pressure variability increases the risk of adverse cardiovascular outcomes in patients with chronic kidney disease. Kidney Int, 2013, 84(2): 381-389.
20.	Shafi T, Sozio SM, Bandeen-Roche KJ, et al. Predialysis systolic BP variability and outcomes in hemodialysis patients. J Am Soc Nephrol, 2014, 25(4): 799-809.
21.	Sumida K, Molnar MZ, Potukuchi PK, et al. Pre-end-stage renal disease visit-to-visit systolic blood pressure variability and post-end-stage renal disease mortality in incident dialysis patients. J Hypertens, 2017, 35(9): 1816-1824.
22.	Chang TI, Tabada GH, Yang J, et al. Visit-to-visit variability of blood pressure and death, end-stage renal disease, and cardiovascular events in patients with chronic kidney disease. J Hypertens, 2016, 34(2): 244-252.
23.	Mezue K, Goyal A, Pressman GS, et al. Blood Pressure variability predicts adverse events and cardiovascular outcomes in chronic kidney disease: a post-hoc analysis of the sprint trial. Am J Hypertens, 2017, 31(1): 48-52.
24.	Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet, 2010, 375(9718): 895.
25.	Mancia G. Prognostic value of long-term blood pressure variability. The Evidence Is Growing, 2011, 57(2): 141-143.
26.	Weber T, Wassertheurer S, Schmidt-Trucksass A, et al. Relationship between 24-hour ambulatory central systolic blood pressure and left ventricular mass: a prospective multicenter study. Hypertension, 2017, 70(6): 1157-1164.
27.	Ohno Y, Kanno Y, Takenaka T. Central blood pressure and chronic kidney disease. World J Nephrol, 2016, 5(1): 90-100.
28.	Karpetas A, Loutradis C, Bikos A, et al. Blood pressure variability is increasing from the first to the second day of the interdialytic interval in hemodialysis patients. J Hypertens, 2017, 35(12): 2517-2526.

1. Parati G, Ochoa JE, Bilo G, et al. Hypertension in chronic kidney disease part 2: role of ambulatory and home blood pressure monitoring for assessing alterations in blood pressure variability and blood pressure profiles. Hypertension, 2016, 67(6): 1102-1110.
2. Flythe JE, Inrig JK, Shafi T, et al. Association of intradialytic blood pressure variability with increased all-cause and cardiovascular mortality in patients treated with long-term hemodialysis. Am J Kidney Dis, 2013, 61(6): 966-974.
3. Rossignol P, Cridlig J, Lehert P, et al. Visit-to-visit blood pressure variability is a strong predictor of cardiovascular events in hemodialysis: insights from FOSIDIAL. Hypertension, 2012, 60(2): 339-346.
4. 赵景新, 张永艳, 陶楠楠, 等. 维持性血液透析患者血压变异性与左心室肥厚的相关性分析. 医学综述, 2017, 23(7): 1450-1453.
5. 陈爱群, 孙颖, 王海涛, 等. 血液透析中血压变异性及影响因素的初步探讨. 中华肾脏病杂志, 2013, 29(12): 888-892.
6. Yano Y, Fujimoto S, Kramer H, et al. Long-term blood pressure variability, new-onset diabetes mellitus, and new-onset chronic kidney disease in the Japanese general population. Hypertension, 2015, 66(1): 30-36.
7. Xia Y, Liu X, Wu D, et al. Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population. Sci Rep, 2017, 7(1): 8394.
8. Mena LJ, Felix VG, Melgarejo JD, et al. 24-Hour blood pressure variability assessed by average real variability: a systematic review and meta-analysis. J Am Heart Assoc, 2017, 6(10): 1076-1085.
9. Tanner RM, Shimbo D, Dreisbach AW, et al. Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study. BMC Nephrol, 2015, 16: 84.
10. Flythe JE, Brunelli SM. Blood pressure variability among chronic dialysis patients: recent advances in knowledge. Curr Opin Nephrol Hypertens, 2015, 24(2): 163-169.
11. Chi C, Yu SK, Auckle R, et al. Association of left ventricular structural and functional abnormalities with aortic and brachial blood pressure variability in hypertensive patients: the SAFAR study. J Hum Hypertens, 2017, 31(10): 633-639.
12. Wei FF, Li Y, Zhang L, et al. Beat-to-beat, reading-to-reading, and day-to-day blood pressure variability in relation to organ damage in untreated Chinese. Hypertension, 2014, 63(4): 790-706.
13. Gosmanova EO, Mikkelsen MK, Molnar MZ, et al. Association of systolic blood pressure variability with mortality, coronary heart disease, stroke, and renal disease. J Am Coll Cardiol, 2016, 68(13): 1375-1386.
14. Omboni S, Posokhov IN, Rogoza AN. Relationships between 24-h blood pressure variability and 24-h central arterial pressure, pulse wave velocity and augmentation index in hypertensive patients. Hypertens Res, 2017, 40(4): 385-391.
15. Chen Y, Xiong H, Wu D, et al. Relationship of short-term blood pressure variability with carotid intima-media thickness in hypertensive patients. Biomed Eng Online, 2015, 14: 71.
16. Yokota K, Fukuda M, Matsui Y, et al. Impact of visit-to-visit variability of blood pressure on deterioration of renal function in patients with non-diabetic chronic kidney disease. Hypertens Res, 2013, 36(2): 151-157.
17. Gorostidi M, Sarafidis P, Sierra AL, et al. 3D.02: blood pressure variability increases with advancing chronic kidney disease stage. a cross-sectional analysis of 14,382 hypertensive patients from spain. J Hypertens, 2015, 33(23): e40.
18. 谷立杰, 张郁苒, 袁伟杰, 等. 维持性血液透析患者透析中血压变异性的相关因素及其对预后的影响. 中华内科杂志, 2013, 52(6): 453-458.
19. Mallamaci F, Minutolo R, Leonardis D, et al. Long-term visit-to-visit office blood pressure variability increases the risk of adverse cardiovascular outcomes in patients with chronic kidney disease. Kidney Int, 2013, 84(2): 381-389.
20. Shafi T, Sozio SM, Bandeen-Roche KJ, et al. Predialysis systolic BP variability and outcomes in hemodialysis patients. J Am Soc Nephrol, 2014, 25(4): 799-809.
21. Sumida K, Molnar MZ, Potukuchi PK, et al. Pre-end-stage renal disease visit-to-visit systolic blood pressure variability and post-end-stage renal disease mortality in incident dialysis patients. J Hypertens, 2017, 35(9): 1816-1824.
22. Chang TI, Tabada GH, Yang J, et al. Visit-to-visit variability of blood pressure and death, end-stage renal disease, and cardiovascular events in patients with chronic kidney disease. J Hypertens, 2016, 34(2): 244-252.
23. Mezue K, Goyal A, Pressman GS, et al. Blood Pressure variability predicts adverse events and cardiovascular outcomes in chronic kidney disease: a post-hoc analysis of the sprint trial. Am J Hypertens, 2017, 31(1): 48-52.
24. Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet, 2010, 375(9718): 895.
25. Mancia G. Prognostic value of long-term blood pressure variability. The Evidence Is Growing, 2011, 57(2): 141-143.
26. Weber T, Wassertheurer S, Schmidt-Trucksass A, et al. Relationship between 24-hour ambulatory central systolic blood pressure and left ventricular mass: a prospective multicenter study. Hypertension, 2017, 70(6): 1157-1164.
27. Ohno Y, Kanno Y, Takenaka T. Central blood pressure and chronic kidney disease. World J Nephrol, 2016, 5(1): 90-100.
28. Karpetas A, Loutradis C, Bikos A, et al. Blood pressure variability is increasing from the first to the second day of the interdialytic interval in hemodialysis patients. J Hypertens, 2017, 35(12): 2517-2526.

Chinese Journal of Evidence-Based Medicine

Clinical significance of blood pressure variability in chronic kidney disease and hemodialytic patients

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