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Relationship Between Short‐Term Blood Pressure Variability and Subclinical Renal Damage in Essential Hypertensive Patients
Authors:Giuseppe Mulè MD  Ilenia Calcaterra MD  Miriam Costanzo MD  Giulio Geraci MD  Laura Guarino MD  Anna C. Foraci MD  Maria G. Vario MD  Giovanni Cerasola MD  Santina Cottone MD
Affiliation:Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
Abstract:The authors aimed to analyze the relationship between subclinical renal damage, defined as the presence of microalbuminuria or an estimated glomerular filtration rate (eGFR) between 30 mL/min/1.73 m2 and 60 mL/min/1.73 m2 and short‐term blood pressure (BP) variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24‐hour BP, and SD of daytime and nighttime BP. A total of 328 hypertensive patients underwent 24‐hour ambulatory BP monitoring, 24‐hour albumin excretion rate determination, and eGFR calculation using the Chronic Kidney Disease Epidemiology Collaboration equation. ARV of 24‐hour systolic BP (SBP) was significantly higher in patients with subclinical renal damage (P=.001). This association held (P=.04) after adjustment for potential confounders. In patients with microalbuminuria, ARV of 24‐hour SBP, weighted SD of 24‐hour SBP, and SD of daytime SBP were also independently and inversely related to eGFR. These results seem to suggest that in essential hypertension, short‐term BP variability is independently associated with early renal abnormalities.
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