The Prognostic Role of Automated Office Blood Pressure Measurement in Hypertensive Patients with Chronic Kidney Disease

• Published in: Healthcare (Basel) Vol. 11; no. 10; p. 1360
• Main Authors: Psounis, Konstantinos, Andreadis, Emmanuel, Oikonomaki, Theodora, Roumeliotis, Stefanos, Margellos, Vasileios, Thodis, Elias, Passadakis, Ploumis, Panagoutsos, Stylianos
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.05.2023; MDPI
• Subjects: Analysis; Antihypertensives; automated office blood pressure; Automation; Blood pressure; Cardiovascular disease; cardiovascular events; Cholesterol; chronic kidney disease; Chronic kidney failure; Creatinine; Development and progression; Diabetes; Hemodialysis; Hospitals; Hypertension; Kidney diseases; Measurement; Medical prognosis; Peritoneal dialysis; Prognosis; Regression analysis; renal events; Urine; Greece; cardiovascular events; chronic kidney disease; renal events; automated office blood pressure; hypertension
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare11101360

The aim of this study was to evaluate the prognostic value of automated office blood pressure (AOBP) measurement in patients with hypertension and chronic kidney disease (CKD) stage 3-5 not on dialysis. At baseline, 140 patients were recruited, and blood pressure (BP) measurements with 3 different methods, namely, office blood pressure (OBP), AOBP, and ambulatory blood pressure measurement (ABPM), were recorded. All patients were prospectively followed for a median period of 3.4 years. The primary outcome of this study was a composite outcome of cardiovascular (CV) events (both fatal and nonfatal) or a doubling of serum creatine or progression to end-stage kidney disease (ESKD), whichever occurred first. At baseline, the median age of patients was 65.2 years; 36.4% had diabetes; 21.4% had a history of CV disease; the mean of estimated glomerular filtration rate (eGFR) was 33 mL/min/1.73 m ; and the means of OBP, AOBP, and daytime ABPM were 151/84 mm Hg, 134/77 mm Hg, and 132/77 mm Hg, respectively. During the follow-up, 18 patients had a CV event, and 37 patients had a renal event. In the univariate cox regression analysis, systolic AOBP was found to be predictive of the primary outcome (HR per 1 mm Hg increase in BP, 1.019, 95% CI 1.003-1.035), and after adjustment for eGFR, smoking status, diabetes, and a history of CV disease and systolic and diastolic AOBP were also found to be predictive of the primary outcome (HR per 1 mm Hg increase in BP, 1.017, 95% CI 1.002-1.032 and 1.033, 95% CI 1.009-1.058, respectively). In patients with CKD, AOBP appears to be prognostic of CV risk or risk for kidney disease progression and could, therefore, be considered a reliable means for recording BP in the office setting.