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Increased nighttime pulse pressure variability but not ambulatory blood pressure levels predicts 14-year all-cause mortality in patients on hemodialysis

Hypertension Aug 02, 2019

Huang JT, et al. – In a sample of patients (n=149; 53.0% male; mean age: 54.5 ± 15.1 years) on regular hemodialysis for > 6 months, researchers assessed the long-term prognostic value of the short-term blood pressure (BP) variability. A 44-hour (excluding the hemodialysis session) ambulatory BP monitoring was performed. Also, comprehensive hemodynamic evaluations were carried out. Thereafter, the investigators calculated BP variability parameters, such as average real variability (ARV) of systolic BP, diastolic BP, and pulse pressure (ARVp) during daytime, nighttime, and overall 44 hours. A median follow-up of 14 years was performed. Findings revealed that long-term all-cause mortality in hemodialysis patients was significantly predicted by increased short-term nighttime pulse pressure variability but not by ambulatory BP levels. The two most significant determinants of nighttime ARVp identified in this study were forward wave amplitude and 44-hour systolic BP.

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