Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with prim
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RESEARCH ARTICLE
Open Access
Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease Ruo-wei Wen1,2†, Xiao-qiu Chen1,2†, Ye Zhu1,2, Jian-ting Ke1,2, Yi Du1,2, Cheng Wang1,2* and Tan-qi Lou3
Abstract Background: Blood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease. Methods: 1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR< 60 ml/min/1.73m2), albumin-to-creatinine ratio (ACR ≥ 30 mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD. Results: Among 1178 patients (mean age, 39 years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR < 60 ml/min/1.73m2, ACR ≥ 30 mg/g and cIMT≥0.9 mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP (P < 0.05). Multivariate logistic regression analyses showed that 24 h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR< 60 ml/min/1.73m2 and ACR ≥ 30 mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP. Conclusions: Ambulatory blood pressure, especially nighttime blood pressure, is probably superior to clinic blood pressure and has a significant association with TOD in primary glomerular disease patients. Keywords: Ambulatory blood pressure, Clinic blood pressure, Target organ damage, Primary glomerular disease
* Correspondence: [email protected] † Ruo-wei Wen and Xiao-qiu Chen contributed equally to this work. 1 Division of Nephrology, Department of Medicine, the Fifth affiliated hospital Sun Yat-Sen University, ZhuHai 519000, Guangdong, China 2 Guangdong Provincial Key Laboratory of Biomedical Imaging, the Fifth affiliated hospital Sun Yat-Sen University, Zhuhai 519000, Guangdong, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the or
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