Relationship of Ambulatory Blood Pressure and the Heart Rate Profile with Renal Function Parameters in Hypertensive Patients with Chronic Kidney Disease

Abstract

Strict blood pressure (BP) control is reportedly important for the management of hypertensive patients with chronic kidney disease (CKD). The purpose of this cross-sectional study was to examine whether the variables of ambulatory BP and the heart rate (HR) profile, central hemodynamics, and arterial stiffness were closely related to the renal function parameters (urine albumin excretion rate [UACR] and estimated glomerular filtration rate [eGFR]) observed in 25 consecutive hospitalized hypertensive patients with CKD. There were significant positive relationships between UACR and 24-hour, daytime, and nighttime ambulatory systolic BP. In addition, there were significant negative relationships between UACR and 24-hour and daytime HR variability. The circulating B-type natriuretic peptide level and hemoglobin A1c were also positively related to UACR. With respect to eGFR, although the 24-hour and nighttime HR variability were positively associated with eGFR, the circulating pentosidine and nighttime HR had a negative relationship with eGFR. On the other hand, central hemodynamics and arterial stiffness did not exhibit any significant association with renal function parameters. These results indicate that ambulatory BP and the HR profile are closely modulated by renal function deterioration. Further studies are needed to investigate the causal relationship between ambulatory BP and the HR profile and renal function parameters in hypertensive patients with CKD.

• ambulatory BP monitoring
• hypertension
• chronic kidney disease
• HR variability
• central BP
• arterial stiffness
• oxidative stress

ACKNOWLEDGMENTS

This study was supported in part by grants from the Japanese Ministry of Education, Science, Sports and Culture, by Health and Labor Sciences Research grant, and by grants from Salt Science Research Foundation (No. 1134) and the Kidney Foundation, Japan (JKFB11-25). Pacific Edit (Dr. Kevin Boru) reviewed the manuscript prior to submission.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.