Ambulatory blood pressure in hypertensive patients with autosomal dominant polycystic kidney disease

Background: Ambulatory blood pressure is more closelycorrelated with various indices of hypertensive target-organ damage, and isa better prognostic predictor of cardiovascular morbidity and mortalitythan conventional methods of blood pressure measurement. Autosomal dominantpolycystic kidney disease (ADPKD) is complicated by hypertension,progressive renal failure, and an increased risk of cardiovascularmortality. This study investigated the 24-h ambulatory blood pressureprofile in patients with ADPKD in view of the sparsity of such data inthese patients and the possibility that abnormal diurnal blood pressurevariations may have prognostic consequences. Methods:Ambulatory blood pressure was measured over a 24-h period by theoscillometric method with an automatic non-invasive recorder (SpaceLabs90207 system) in matched groups of 25 hypertensive patients with ADPKD and25 patients with essential hypertension. Results: Bothgroups showed a nocturnal decrease in blood pressure, but this wassignificantly smaller in patients with ADPKD. There was no evidence ofenhanced lability of blood pressure in ADPKD.Conclusion: The nocturnal fall in blood pressure wasattenuated in patients with ADPKD. Further studies are required to assessthe importance of this finding and its possible contribution to theprogression of renal failure or increased cardiovascular mortality in thesepatients.