This blood pressure monitoring method may help people with kidney problems

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Two recent studies from the University of Alabama at Birmingham found that “ambulatory” blood pressure monitoring, which is conducted while people go about their daily activities, including during sleep, may benefit people with kidney disease.

This type of monitoring can provide more information than blood pressure measurements taken only in clinics.

The study findings are published in CJASN. The lead author is Paul Muntner, MD.

High blood pressure has a range of effects on the body that can influence both physical and mental health.

In an analysis of 561 people with and without chronic kidney disease who underwent ambulatory blood pressure monitoring, the team found that having kidney disease was linked to uncontrolled blood pressure measured in the clinic and outside of the clinic.

Also, among people with kidney disease, uncontrolled ambulatory blood pressure was associated with a higher prevalence of left ventricular hypertrophy, a marker of heart disease.

In another study that followed 1,502 adults with chronic kidney disease for 4 years, the team found that ambulatory blood pressure patterns were not linked with cognitive impairment or frailty.

However, among people older than 60 years, those who demonstrated at least a 20% drop in average systolic blood pressure from day to night—called extreme dippers—had a higher risk of developing cognitive impairment.

Also, participants with masked high blood pressure (normal clinic-measured blood pressure but elevated ambulatory blood pressure) had worse physical functioning than participants with high blood pressure controlled with medication.

The team says getting an accurate estimate of blood pressure is important for people with kidney disease given the association of blood pressure with heart disease and kidney disease.

The current findings showed that a high proportion of people with kidney disease have high blood pressure when measured outside of the doctor’s office.

Future research should assess links between ambulatory blood pressure and physical and cognitive function over a longer follow-up period.

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