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Titolo:
Ambulatory blood pressure monitoring in nephrology: focus on BP variability
Autore:
Covic, A; Goldsmith, DJA;
Indirizzi:
Case Western Reserve Univ, Univ Hosp Cleveland, Div Nephrol & Hypertens, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA
Titolo Testata:
JOURNAL OF NEPHROLOGY
fascicolo: 4, volume: 12, anno: 1999,
pagine: 220 - 229
SICI:
1121-8428(199907/08)12:4<220:ABPMIN>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC-RENAL-FAILURE; RECOMBINANT-HUMAN-ERYTHROPOIETIN; CHRONIC-HEMODIALYSIS PATIENTS; LEFT-VENTRICULAR HYPERTROPHY; DIALYSIS PATIENTS; DIABETIC NEPHROPATHY; CAPD PATIENTS; LONG-TERM; ECHOCARDIOGRAPHIC FINDINGS; NOCTURNAL HYPERTENSION;
Keywords:
ABPM; BP variability; non-dippers; target-organ damage; arterial baroreflexes; arterial calcifications; arterial compliance;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
88
Recensione:
Indirizzi per estratti:
Indirizzo: Covic, A Case Western Reserve Univ, Univ Hosp Cleveland, Div Nephrol & Hypertens, 11100 Euclid Ave, Cleveland, OH 44106 USA Case Western Reserve Univ11100 Euclid Ave Cleveland OH USA 44106
Citazione:
A. Covic e D.J.A. Goldsmith, "Ambulatory blood pressure monitoring in nephrology: focus on BP variability", J NEPHROL, 12(4), 1999, pp. 220-229

Abstract

As accurate assessment of hypertension in renal patients must be the cornerstone of better prevention of its deleterious effects, ambulatory blood pressure monitoring (ABPM) has become an essential clinical and research procedure in day to day nephrological practice. However, despite numerous studies in the renal literature, a consensus is needed for normal (desirable?!) ambulatory daytime and nighttime BP levels and for defining normal sleep BPdipping. Nevertheless, blunted sleep BP fall appears to be a ubiquitous finding in renal disease (primary renal conditions, chronic renal failure pre-dialysis, peritoneal and hemodialysis, and renal transplantation). Abnormal diurnal variability should be considered as an important contributor to cardiac and general morbidity as it is clearly associated with a faster decline in renal function and also with more cardiac structural and functional abnormalities - especially left ventricular dilatation. Several mechanisms have been proposed to explain the reduced BP circadian rhythm, but the majority of the supporting evidence is still contradictory. A novel, unifying hypothesis to be tested in future studies, is linking the common diurnal rhythm abnormalities with functional disturbances in aortic and carotid baroreflexes caused by uraemia-related large arterial structural changes (arterial intima and media thickening, arterial calcifications and increased arterial stiffness).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 21:45:01