Investigation of the correlation of the parameters of 24-hour ambulatory blood pressure monitoring and cardiac function in maintenance hemodialysis patients

Objective To analyze the relationship between the parameters of 24-hour ambulatory blood pressure monitoring(ABPM) and cardiac function in maintenance hemodialysis(MHD) patients.Methods Thirty-one MHD patients and 31 pre-ESRD patients were enrolled.24-hour average systolic(24h-SBP),24-hour average diastolic(24h-DBP),24-hour average mean arterial(24h-MAP),Daytime average systolic(D-SBP),Daytime average diastolic(D-DBP),Night-time average systolic(N-SBP),Nighttime average diastolic(N-DBP) blood pressure and circadian blood pressure rhythm were measured by ABPM.The left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),left atrial diameter(LAD),left ventricu-lar posterior wall thickness(LVPWT),interventricular septal thickness(IVST)were detected by ultrasonic cardiography.And other correlated parameters were also measured.Results The left ventricular hypertrophy(LVH),LVDd,LVDs and LVMI increased in MHD patients compared with pre-ESRD patients,while the fractional shortening decreased significantly.The levels of 24h-SBP,24h-DBP,24h-MAP,D-SBP,D-DBP,N-SBP and N-DBP increased significantly in MHD patients compared with the pre-ESRD patients,especially the non-dipper hypertension(90.3% vs 64.5%,P= 0.015).The percentage of hypertension at 24-hour average,Daytime average,Nighttime average blood pressure and N-SBP were higher in MHD patients compared with the control group.The non-dipper blood pressure in MHD patients whose 24-hour average blood pressure lower than 135/85mm Hg were 87.5%.The blood pressure was found positively correlated with cardiac function,especially the SBP and non-dipper blood pressure rhythm.On the other hand,Alb、 iPTH、duration of hemodialysis were also correlated with cardiac function.Conclusion The incidence of hypertension and non-dipper hypertension is very high in MHD patients.The cardiac function in maintenance hemodialysis is closely correlated with non-dipper blood pressure rhythm and high N-SBP.