Response to exercise and ambulatory blood pressure monitoring in essential hypertension

To evaluate the relationship of ambulatory blood pressure (ABP) recording and blood pressure response to exercise, 58 essential hypertensive patients, not taking any drugs, had symptom-limited treadmill stress test (TST) within 48-96 hours of ABP, TST time, blood pressure increase, decrease, mode of increase and decrease, were independent of ABP systolic (SBP) and diastolic blood pressure (DBP) over 24 hours, day time and night time (p = ns). SBP decrease immediately after exercise were independent of ABP data. TST achieved heart rate was related to both 24 hours SBP (r = -0.64, p = 0.00005) and DBP (r = -0.55, p = 0.00001) in both day (r = -0.64, p = 0.00001 and r = -0.54, p = 0.002) and night (r = -0.52, p = 0.0001 and r = -0.46, p = 0.003) time periods. Therefore patients with achieved heart rate < 100% (n = 18) had higher 24 hour SBP (148 vs 132 +/- 2 mm Hg, p = 0.0006) and DBP (92.4 +/- 6.4 vs 84 +/- 6.2 mm Hg, P = 0.006) day and night. It is concluded that there is no overlap of diagnostic information using blood pressure. Values in TST or ABP although achieved heart rate in exercise is inversely related to severity of hypertension.     

Reproducibility of blood pressure and heart rate reactivity: A meta-analysis

Reproducibilities of blood pressure and heart rule (HR) reactivity reported in studies assessing responses to the same laboratory stressors across occasions were reviewed with meta-analytic techniques. Changes in HR had the greatest reproducibility (r =.555), followed by systolic blood pressure (SBP) (.407) and diastolic blood pressure (DBF) (.348), Both SBP and HR response reproducibility was higher at shorter lest-retest intervals, whereas DBP values varied unsystematically with length of test-retest interval Older samples exhibited higher SBP and DBP reproducibility to stressors. SBP and DBP reproducibilities were better for tasks that did not make speech demands. The reliability of reactivity assessment was higher when based on three or more measurements, On the basis of able evidence, the drop in stress reproducibility, as test-retest interval increases, places limits on the viability of BP reactivity as a strong marker or risk factor for coronary heart disease.     

Laboratory-based blood pressure recovery is a predictor of ambulatory blood pressure

The recovery phase of the stress response is an individual difference characteristic that may predict cardiovascular risk. The purpose of this study was to examine whether laboratory-based blood pressure (BP) recovery predicts ambulatory BP (ABP). One hundred and eighty-two participants underwent a standard laboratory stress protocol, involving a 20-min baseline rest period, and four stressors presented in a counterbalanced order, each followed by a 10-min recovery period. Participants also wore an ABP monitor for 24h during a typical workday. Hierarchical regression analyses showed that BP recovery accounted for significant additional variance for daytime SBP (p<0.001), nighttime SBP (p<0.001), daytime DBP (p<0.001), and nighttime DBP (p<0.001), after controlling for baseline and reactivity BP. Results suggest that persistence of the BP response following stress may be a more salient characteristic of the stress response in understanding its potential impact on longer term cardiovascular regulation.     

Ambulatory blood pressure monitoring and laboratory reactivity in type A behavior and components

Type A coronary-prone behavior has been characterized previously by cardiovascular hyperreactivity to laboratory stressors. The objectives of this study were: 1) to determine whether cardiovascular patterns under more naturalistic circumstances in the field were altered in Type A subjects, and 2) to determine whether these field patterns paralleled cardiovascular patterns to a series of stressors in the laboratory. Thirty-three healthy Type A and B men underwent 24-hr ambulatory blood pressure and heart rate monitoring during a normal day of activities. These subjects were also tested in the laboratory for blood pressure and heart rate responses to a series of stressor tasks: 1) cognitive (mental arithmetic), 2) perceptual motor (reaction time), and 3) physical (handgrip). Type A behavior and stylistic components were rated by structured interview. All studies were conducted double blindly. Type A subjects demonstrated greater cardiovascular reactivity to the laboratory cognitive stressor, but there was a mixture of differences between As and Bs in variability of ambulatory blood pressure and heart rate during different periods of the day. Yet, there were no differences in average blood pressure levels. The components of verbal competition and loudness of voice were positively associated with elevated average blood pressure and variability in the field, respectively, but not with laboratory hyperreactivity. Thus, this study confirmed laboratory-induced cardiovascular hyperreactivity in Type A behavior but, within its limitations, did not find a similarity between laboratory and field cardiovascular response patterns in these behavioral groups. The ambulatory blood pressure monitoring findings in the component groups may have prognostic significance and deserve further study.     

Religious coping, ethnicity, and ambulatory blood pressure

OBJECTIVE: To investigate the relationship between religious coping, ethnicity, and ambulatory blood pressure (ABP) measured during daily life. METHODS: A 24-hour ABP was obtained from 155 men and women (78 African American and 77 white) on a typical workday. ABP was averaged over awake and sleep periods, and clinic BP was also assessed. Psychosocial measures of coping style, negative affect, social support, stress, and health behaviors were completed before ABP measurement. RESULTS: Multiple regression analyses, controlling for demographic variables, revealed a significant religious coping by ethnicity interaction for ABP (p < .01) and clinic BP (p < .05). Religious coping was not related to BP among whites. Among African Americans, however, higher levels of religious coping were associated with lower awake (p < .05) and sleep (p < .01) ABP. Social support satisfaction also was related to lower awake ABP among African Americans, but it did not mediate the relationship between religious coping and ABP. CONCLUSIONS: The results of this study extend previous findings by showing that, among African Americans, religious coping and BP are related during daily activities as well as in the clinic. Lower 24-hour BP load may be a pathway through which religiosity and cardiovascular health are related.     

Caffeine, extended stress, and blood pressure in borderline hypertensive men

Caffeine increases blood pressure (BP), and its pressor effects are larger in borderline hypertensive (BH) men than in controls. This article extends findings of larger caffeine effects on BP at rest and to brief mental stress in BH to a new analysis of caffeine and prolonged mental stress in BH. In a double-blind, crossover study, 24 male BH (140/90 mmHg < BP < 160/95 mmHg) and 23 normotensive controls who were habitual caffeine consumers (NT; BP < 135/85 mmHg; negative parental history) worked on alternating mental stressors for 35 min after placebo or caffeine (3.3 mg/kg). Caffeine raised systolic blood pressure (SBP) and diastolic blood pressure (DBP) alone and during the extended tasks (all ps < .00001/.00001). BH had larger SBP and DBP increases over all postcaffeine periods (ps < .04/04) and larger DBP rises to the extended tasks after caffeine (p = .007). These combined effects led to undesirably high BPs (> 140/82 mmHg) relative to controls (< 130/75) during the 100 min after caffeine intake. Caffeine taken by BH at times of extended behavioral stress may elevate BP to a clinically meaningful degree. This research was supported by the Medical Research Service of the Department of Veterans Affairs and the National Heart Lung and Blood Institute of the National Institutes of Health, grant numbers HL32050 and HL07640. We thank Barbara McKey and Judith Silverstein for their efforts in data collection and Terrie Thomas for her valuable comments on an earlier version of this article.     

Circadian blood pressure patterns and life stress

BACKGROUND: Scarce data are available on the influence of psychological aspects on 24-hour ambulatory blood pressure patterns either in normotensive or hypertensive subjects. This study was designed to evaluate the relationship between psychological profile and changes in daytime/nighttime blood pressure rhythm. METHODS: Nocturnal dipping was defined as the night/day ratio of ambulatory mean systolic and/or diastolic blood pressure < or =0.87. Three-hundred and two outpatients (M/F = 174/128; mean age = 49.8 years, SD = 13.6; range, 16-80 years) underwent 24-hour ambulatory blood pressure monitoring. They were administered a self-rating scale, the Psychosocial Index, as an indicator of stress, psychological distress, sleep disturbances, well-being, abnormal illness behavior and quality of life. There were 242 patients taking antihypertensive medication (146 adequately controlled and 96 not controlled) and 60 who were drug free (33 never-treated hypertensive and 27 normotensive subjects). Patients were divided according to the presence (n = 125) or absence (n = 177) of night blood pressure dipping. The two groups were compared using analysis of covariance, with age as a covariate. RESULTS: Dippers had lower (p < 0.001) nocturnal systolic and diastolic blood pressure than nondippers, and higher (p < 0.05) daytime diastolic blood pressure. Patients with nocturnal blood pressure decline had a markedly higher (p < 0.001) level of stress than nondippers. When the sample was divided according to the presence or absence of hypertension, only subjects with normal blood pressure showed nocturnal dipping associated with increased stressful life circumstances. CONCLUSIONS: Our findings indicate that dippers experience stressful life circumstances, both in terms of life events and chronic stress. This suggests that stress-reducing techniques may be particularly helpful in the setting of hypertension characterized by nighttime blood pressure dipping.     

Ethnic differences in cardiovascular responses to laboratory stress: A comparison between asian and white americans

Compared to other ethnic groups, Asian Americans show significantly lower rates of cardiovascular disease (CVD). We tested the hypothesis that Asian Americans would show reduced cardiovascular responses to laboratory stressors than Caucasians. Forty-three Asians (18 men, 25 women) and 77 Caucasians (36 men, 41 women) with a mean age of 24 years (SD = 3.93) participated in a stress reactivity protocol consisting of four tasks (speech, serial subtraction, mirror tracing, handgrip) while heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured. Asian Americans demonstrated overall lower reactivity across tasks for SBP F(1,117 = 7.48, p < .01) and a trend toward lower HR response F(1,117 = 3.18, p < .10). A significant ethnicity by task interaction was observed for HR reactivity F(3,351 = 2.94, p < .05) such that Caucasians showed greater responses for the subtraction task.     

Predicting ambulatory blood pressure during school: Effectiveness of social and nonsocial reactivity tasks in black and white adolescents

We evaluated a newly developed stress task, the Social Competence Interview, and three nonsocial tasks (video game, mirror drawing, mental arithmetic) for ability to predict ambulatory blood pressure in 237 black and white adolescents. Blood pressure was measured in laboratory, classroom, and transition (between-class) settings. A resting laboratory baseline explained 10–49% of the variance in ambulatory blood pressure levels; the ability of the stress tasks to explain additional variance was assessed in multiple regression analyses. Only the blood pressure response to the interview enhanced prediction of classroom and transition systolic and diastolic pressures in the total sample and in blacks, whites, females, and males – even when the interview data were entered into a hierarchical regression model after those for the other three tasks were entered. Mirror drawing improved prediction of transition systolic blood pressure in the total sample, and mental arithmetic plus the interview improved prediction of classroom diastolic pressure in black males; however, video game failed to enter any predictive equation. Racial subgroup analyses disclosed that the interview data predicted systolic pressure in whites but predicted diastolic pressure in blacks, indicating biological differences in blood pressure regulation. An interview that elicits characteristic thoughts and social behaviors appears to represent a promising approach to examining environmental influences on blood pressure.     

Hydration status and cardiovascular function: effects of hydration enhancement on cardiovascular function at rest and during psychological stress.

This study examined the effects of a 3-day enhanced hydration regimen on resting cardiac function and reactivity to acute stress. Healthy volunteers (14 male, 14 female) were assigned to one of two groups: Enhanced Hydration and Normal Hydration Group. Participants in the Enhanced Group were given six 1-l bottles of water and instructed to drink two bottles a day in addition to normal fluid intake for 3 days preceding their laboratory session; no extra water was given to the Normal Group. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac output (CO), stroke volume (SV), and total peripheral resistance (TPR) were recorded during a 10-min baseline, 6-min Paced Auditory Serial Addition Test (PASAT), 5-min recovery, 5-min intermediate baseline, and 3-min Cold Pressor Test. Repeated-measures ANOVA revealed a significant Hydration GroupxTask interaction for DBP during the cold pressor (p<0.01) with the Enhanced Group exhibiting greater DBP reactivity to cold stress relative to the Normal Group. Analysis revealed significant Hydration GroupxGender interactions for SV and TPR (p<0.05) at rest and during both the PASAT and Cold Pressor Test. Females in the Enhanced Group displayed higher SV and lower TPR relative to Enhanced Group males, whereas females in the Normal Group displayed lower SV and greater TPR relative to Normal Group males. These results suggest that 3-day hydration enhancement influences blood pressure reactivity in both men and women, and that long-term hydration enhancement is related to resting gender differences in cardiac function.     

Influence of cholesterol and fasting insulin levels on blood pressure reactivity

OBJECTIVE: This study examined how cholesterol and fasting insulin levels are related to blood pressure reactivity to behavioral stressors. METHODS: Subjects (N = 116) were 20 to 52 years old, at 80% to 150% of ideal weight, and had an average fasting cholesterol level of 183 mg/dl. Stressor tasks included mirror star tracing and a videotaped speech task. Changes from baseline were calculated for systolic and diastolic blood pressure. RESULTS: Neither cholesterol nor insulin was independently related to blood pressure change scores. However, after controlling for body mass, a two-way analysis of variance revealed a significant cholesterol-by-insulin interaction for change in diastolic blood pressure (p = .022). Subjects in the high-cholesterol/high-insulin group showed the greatest increase in diastolic blood pressure reactivity. CONCLUSIONS: In a general population, people with a below-average cholesterol level experience only moderate cardiovascular reactivity to mental stressors regardless of their fasting insulin level. However, for people with an above-average cholesterol level, fasting insulin level is an important factor in determining potential reactivity to mental stressors. These findings highlight the importance of adequate sample size to allow for the analysis of such interactions in future studies of cholesterol, insulin, and blood pressure reactivity.     

Cardiovascular responses in Type A and Type B men to a series of stressors

Fifty-six healthy adult males were administered the Type A Structured Interview and assessed as exhibiting either Type A (N=42) or Type B (N=14) behavior pattern. They were monitored for systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) responses during a series of six challenging tasks: Mental Arithmetic, Hypothesis Testing, Reaction Time, Video Game, Handgrip, and Cold Pressor. The results indicated that Type A subjects exhibited greater cardiovascular responses than did Type B subjects during some (Hypothesis Testing, Reaction Time, Video Game and Mental Arithmetic) but not all (Handgrip and Cold Pressor) of the tasks. These results are discussed in terms of previously reported findings on conditions that do and do not produce differences in Type A/B cardiovascular stress responses. This research was supported by USPHS Grant MH-31269. We would like to thank Drs. Steve Manuck, David Krantz, Ted Dembroski, Curt Sandman, David Hothersall, and Gifford Weary for their helpful comments on an earlier draft of this paper.     

Relationship between blood pressure reactions on an ergometric and an emotional stress test

Summary The relationship between blood pressure reactions on an ergometric and an emotional stress test was studied in a population of 62 normotensive subjects. Significant correlations for systolic (r=0.34,p=0.004) and diastolic (r=0.30,p=0.01) blood pressure were found.It is concluded that 1) there is a individual-specific blood pressure reactivity, 2) Hypertension is closely related to the individualspecific systolic blood pressure reactivity for it is known that hypertensives exhibit stronger systolic blood pressure reactions on both stressors.     

Increased ambulatory arterial stiffness index and blood pressure load in normotensive obese patients

ObjectivesIt has been shown that blood pressure (BP) values measured in obese subjects are higher than the individuals with normal weight, even in normotensive limits. However, data concerning the Ambulatory Arterial Stiffness Index (AASI) and blood pressure load in normotensive obese subjects is lacking. This study was aimed to compare the ambulatory arterial stiffness index and blood pressure load in normotensive obese and healthy controls.MethodsOne hundred normotensive obese and one hundred normal weight subjects were included in this study. All subjects underwent 24-hour ambulatory blood pressure monitoring. Ambulatory arterial stiffness index was calculated from 24-hour ambulatory blood pressure monitoring records. Ambulatory arterial stiffness index was defined as one minus the regression slope of unedited 24-h diastolic on systolic blood pressures. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) load values were calculated from 24-hour ambulatory blood pressure monitoring analysis.ResultsAmbulatory arterial stiffness index of the obese subjects was significantly higher than the healthy controls (0.48±0.2 vs. 0.33±0.11, p<0.001). 24-hours systolic blood pressure and diastolic blood pressure loads were significantly higher in obese subjects. Logistic regression analysis revealed that body mass index (BMI) was an independent predictor for an abnormal ambulatory arterial stiffness ındex (≥0.50) (OR: 1.137, 95% CI: 0.915-1.001, p=0.004).ConclusionBlood pressure load and ambulatory arterial stiffness index are increased in normotensive obese patients. Moreover, body mass index is an independent predictor for an abnormal ambulatory arterial stiffness index. Our results indicate that obese subjects are at higher risk for future cardiovascular events despite normal office BP levels.     

The ability of active versus passive coping tasks to predict future blood pressure levels in normotensive men and women

Casual blood pressure (BP) after a 2-year follow-up interval was determined in 40 normotensive men and women (20 Blacks and 20 Whites), who had been initially tested for cardiovascular responses to a variety of active and passive coping tasks, including active speech, passive speech, reaction time, and forehead cold pressor tasks. Stepwise multiple regression analyses were used to identify the best model for predicting follow-up BP. Average systolic blood pressure (SBP) level during cold pressor stress was the single most powerful predictor of casual SBP over 2 years even after controlling for initial resting SBP. Other predictors of follow-up SBP were initial SBP, parental history of hypertension, and heart rate and SBP during passive speech (final model R(2) = .78). For follow-up diastolic blood pressure (DBP), the only significant predictors were initial DBP and male gender. These results contribute to a growing body of literature that suggests that cardiovascular measures observed during stressors have predictive validity above and beyond that of traditional predictor variables.     

Long-term reproducibility of ambulatory blood pressure in unselected elderly subjects.

The aim of this study was to evaluate the long-term reproducibility and validity of 24-h ambulatory blood pressure measurements (ABPM) in an unselected elderly population. In a rural Finnish community 503 randomly chosen invited persons over 65 years of age participated and went through 24-h ABPM. As part of the validation of the methodology, the reproducibility study was conducted in 26 persons (age 65-76 years). Two identical sets of measurement were performed at 4-12 (median 8) month intervals. The agreement between measurements was assessed by correlation coefficients and standard deviation (SD) of the differences. There were no significant differences in 24-h, daytime and night-time average diastolic blood pressure (DBP) and daytime average systolic blood pressure (SBP) between the two measurements. During the second measurement, 24-h SBP and night-time average SBP were slightly higher than those obtained by the first monitoring. Average 24-h SBP and DBP were 18 and 7 mmHg lower, respectively, than office blood pressure averages. The correlation coefficients were significantly higher for 24-h ambulatory blood pressure than for office blood pressure. The SD of the mean difference between visits was significantly lower for 24-h ambulatory blood pressure than for office blood pressure measurements. These findings show that the long-term reproducibility of ambulatory blood pressure is good in an elderly unselected population and better than the office blood pressure reproducibility.     

Relationships between blood pressure, anthropometric characteristics and blood lipids in high- and low-altitude populations from Central Asia

We studied the relationships between blood pressure, anthropometric characteristics and blood lipids in 72 low altitude (LA) Uighurs (600 m), 91 LA-Kirghizs (900 m), 117 medium altitude (MA) Kazakhs (2100 m) and 94 high altitude (HA) Kirghizs (3200 m). All subjects were male and had a similar age (p = ns, ANOVA; range for all 374 subjects: 18-66 yr). Body weight (Wt), body mass index (BM1) and the sum of four skinfolds (4SF) were significantly lower in HA-Kirghizs than the remaining groups (p < 0.0005, p < 0.0005 and p < 0.05 respectively, ANOVA). However, no difference was found in body fat distribution as detected by waist:hip circumference (WHR) and triceps:subscapular skinfold ratios (TSR; p = ns, ANOVA). Stage 1 hypertension was detected in 18% of LA-Uighurs, 2% of LA-Kirghizs, 4% of MA-Kazakhs and 1% of HA-Kirghizs; stage 2 hypertension was detected in 2% of LA-Uighurs and none of the remaining groups; no subject had stage 3 hypertension (The Joint National Committee on Prevention. Detection, Evaluation and Treatment of High Blood Pressure 1997). Blood cholesterol (CH) and triglycerides (TG) did not differ between groups (p = ns, ANOVA). The relationships between systolic (SBP) or diastolic (DBP) blood pressure and age, Wt, BMI, 4SF, WHR, TSR, CH and TG were independent from altitude (p = ns, ANCOVA). In the pooled sample (n = 374), age explained 1 and 3% of SBP (p < 0.05) and DBP (p < 0.005) variance respectively, Wt was the best predictor of SBP and DBP explaining 11 and 10% of their variance respectively (p < 0.0001) and CH explained 5% of DBP variance (p < 0.0001). In conclusion, hypertension is more frequent in LA- than MA- and HA-subjects from Central Asia. However, anthropometric characteristics and blood lipids do similarly contribute to explain blood pressure in these subjects.     

Short-term variability of systolic blood pressure and heart rate in normotensive subjects

Short-term fluctuations in systolic blood pressure (SBP) and heart rate (HR) and their inter-relationship were analysed in a group of normotensive middle-aged men (n = 16) using a multivariate autoregressive modelling technique. This study is the first to evaluate the beat-to-beat variability of SBP and HR in a group of real normotensive subjects. Direct intra-arterial blood pressure was registered together with ECG using an ambulatory tape recording technique (the Oxford method). Power spectrum density estimated (PSD) were used as a measure of the variability. PSDs were calculated over 3-min periods for four basic physiological conditions: during sleep and in the supine, sitting and standing positions. The inter-relationship between the blood pressure and heart rate variabilities was analysed using a closed-loop model. In agreement with results presented earlier in the literature, the beat-to-beat variation in SBP and HR was concentrated in three typical power spectrum regions: the high-frequency (HF = 0.15-0.35 Hz) region (respiration), the mid-frequency (MF = 0.075-0.15 Hz) region (vasomotor oscillation) and the low-frequency (LF = 0.02-0.075 Hz) region (thermoregulation). The variability changes considerably between different situations, especially that of the MF region. The variability was most prominent in the MF region and in the standing position. The variability was generally smallest in the HF region and in sleep. The results also demonstrate that the beat-to-beat variability in SBP and HR can considerably affect one another.     

皮质下动脉硬化性脑病血压及心率变异性分析

目的和方法：采用动态检测技术观察３１例皮质下动脉硬化性脑病和对照组３１例健康人血压和心率的变异性。结果：患者均存在动态血压异常，其中平均收缩压、平均舒张压超过正常值者２７例（８７％），夜间基底血压异常升高２２例（７１％），血压异常波动２０例（６４％），昼夜节律逆转４例（１３％）。患者心率变异时域指标２４小时内全部正常心动周期的标准差、２４小时内５分钟节段平均正常心动周期的标准差、在一定时间内相邻两正常心动周期差值大于５０毫秒的个数所占的百分比均明显低于对照组，收缩压与心率无显著相关性。结论：提示血压波动及持续的夜间升压现象在该病中起着一定作用，而这种异常可能与患者植物神经系统功能失调有关     

Fluid state and blood pressure control: no differences between APD and CAPD

The aim of this study was to compare fluid state, ambulatory blood pressure, and sodium removal in automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD). This observational, cross-sectional study comprised 20 APD and 24 CAPD patients with a mean duration on peritoneal dialysis of 30 ± 26 and 21 ± 23 months, respectively. Sixty-four percent of the patients were treated with icodextrin. The methods used were 24 hr dialysate and urine collections, standardized 3.86% glucose peritoneal equilibration test (PET), bioimpedance analysis, and 24 hr ambulatory blood pressure monitoring. Extracellular water (ECW) corrected for body weight was 0.23 6 0.03 L/kg both in APD and CAPD patients. The slope normovolemia value according to Chamney was 0.0 6 0.2 L/kg in APD patients and 0.0 6 0.05 L/kg in CAPD patients (not significant [NS]). Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were respectively, 132 ± 25 and 79 ± 8 mm Hg in APD and 129 ± 16 and 76 ± 11 mm Hg in CAPD patients (NS). Sodium concentration in dialysate was respectively, 129.5 ± 3.5 mmol/L in APD and 132.4 ± 4.1 mmol/L in CAPD (p= 0.017). Dialysate sodium removal was 80.6 ± 78.4 mmol/24 hr in APD and 108.7 ± 96.8 mmol/24 hr in CAPD patients (NS). Natriuresis was respectively, in APD 76.6 ± 65.5 mmol/24 hr and in CAPD 93.5 ± 61.7 mmol/24 hr (NS). Total sodium removal was 149.5 ± 76.6 mmol/24 hr in APD and 198.4 ± 75.0 mmol/24 hr in CAPD (p= .039). Despite a higher daily sodium removal in CAPD patients, fluid state and blood pressure were not different between APD and CAPD. In general, volume status and blood pressure appeared to be reasonably controlled in this unselected population.