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Titolo:
LEFT-VENTRICULAR HYPERTROPHY AND AMBULATORY BLOOD-PRESSURE MONITORINGIN CHRONIC-RENAL-FAILURE
Autore:
TUCKER B; FABBIAN F; GILES M; THURAISINGHAM RC; RAINE AEG; BAKER LRI;
Indirizzi:
UNIV LONDON ST BARTHOLOMEWS HOSP MED COLL,SMITHFIELD RENAL UNIT,DEPT NEPHROL LONDON EC1A 7BE ENGLAND UNIV LONDON ST BARTHOLOMEWS HOSP MED COLL,SMITHFIELD RENAL UNIT,DEPT NEPHROL LONDON EC1A 7BE ENGLAND ST BARTHOLOMEWS HOSP,DEPT CARDIOL LONDON ENGLAND ARCISPEDALE ST ANNA,DEPT NEPHROL FERRARA ITALY
Titolo Testata:
Nephrology, dialysis, transplantation
fascicolo: 4, volume: 12, anno: 1997,
pagine: 724 - 728
SICI:
0931-0509(1997)12:4<724:LHAABM>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
RISK-FACTORS; DISEASE; TRANSPLANTATION; HEMODIALYSIS; DIALYSIS; ANEMIA; MASS;
Keywords:
AMBULATORY BLOOD PRESSURE (BP); ANEMIA; CHRONIC RENAL FAILURE (CRF); HYPERTENSION; LEFT VENTRICULAR HYPERTROPHY (LVH);
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
B. Tucker et al., "LEFT-VENTRICULAR HYPERTROPHY AND AMBULATORY BLOOD-PRESSURE MONITORINGIN CHRONIC-RENAL-FAILURE", Nephrology, dialysis, transplantation, 12(4), 1997, pp. 724-728

Abstract

Background, Left ventricular hypertrophy (LVH) is both common and an important predictor of risk of death in end-stage renal failure (ESRF). In mild to moderate chronic renal failure (CRF), the timing of onsetof LVH and the factors involved in its initial development have not been fully elucidated. The present study was undertaken to er;amine theprevalence and potential determinants of echocardiographically determined LVH in this connection, and to compare 24-h ambulatory blood pressure (BP) recordings with BP measured at a previous clinic visit. Methods. From a cohort of 120 non-diabetic patients who had been attendinga nephrology clinic, 118 agreed to participate in the study. Of thesewe selected for analysis 85 stable patients (37 male). Patients with.known cardiovascular disease, those with a history of poor compliancewith antihypertensive medication, and those in whom such medication had been changed in the previous 3 months were excluded. Clinic BP, 24-h ambulatory BP, echocardiography, body mass index (BMI), serum creatinine (SCr), creatinine clearance (CrCl), haemoglobin (Hb), fasting cholesterol (CHOL), triglyceride TRIGL), plasma glucose, calcium (Ca), phosphate (PO4), alkaline phosphatase (ALK PHOS), parathyroid hormone (PTH) concentrations, and 24-h urinary protein were assessed in all patients. Seventy-seven per cent were on antihypertensive medication. Results. LVH was detected in 16% of patients with CrCL >30 ml/min, and 35%of patients with CrCl <30 ml/min. By stepwise regression analysis, ambulatory systolic BP (P < 0.0001), male gender (P < 0.0001), BMI (P < 0.0002), and Hb concentration (P < 0.002) were the only independent determinants of left ventricular (LV) mass. Nocturnal systolic BP (P < 0.02) was the main determinant of LVH in the group of patients with advanced CRF. The correlation between left ventricular mass index (LVMI) and mean 24-h ambulatory systolic BP (r = 0.52, 95% confidence interval 0.50-0.54) mras statistically significantly stronger. than with outpatient systolic BP (r = 0.25, 95% confidence interval 0.23-0.27). The same was true for the correlation between LVMI and mean 24-h ambulatory diastolic BP (r = 0.42, 95% confidence interval 0.40-0.44), and outpatient diastolic BP (r = 0.22, 95% confidence interval 0.20-0.24). Conclusions. Twenty-four hour ambulatory BP recording and echocardiography are required for accurate diagnosis of inadequate BP control and early LVH in patients with chronic renal impairment, independent determinants of which are hypertension, male sex, BMI, and anaemia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 03:02:49