[PP.01.14] HOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (KTR)- VALIDITY OF DIFFERENT SCHEDULES OF SELF-MONITORING

    loading  Checking for direct PDF access through Ovid

Abstract

Objective:

Office blood pressure (OBP), 24-h ambulatory monitoring (ABPM) and home self- monitoring (HBP) allow assessing BP control in treated HT patients. For HBP, ESH guidelines recommend 7 days of measurements but that duration is questioned. The present study analyzed the degree of agreement between daytime ABPM and different schedules with decreasing number of days for HBP recording in 70 treated hypertensive KTR.

Design and method:

BP control defined by OBP <140/90 and daytime ABPM or HBP <135/85 mmHg was tested in 70 KTR (mean age 56 ± 11 y; mean graft survival 7 ± 6.6 y). OBP and HBP were measured with an Omron M6 and 24-h ABPM with a Spacelabs 90207. HBP was measured on consecutive days (2 times in morning and 2 times at evening/day), the first day was discarded for the mean calculation. Agreement on BP status between daytime and HBP was studied when HBP was measured during 7, 5 or 3 days.

Results:

BP was uncontrolled in 50% of the KTR based on OBP, in 61 % according to daytime ABPM and even in 64 % with HBP. Sensitivity (Se) testing agreement between daytime ABPM and HBP decreased progressively when number of days of BP recordings was shortened: the highest Se was observed for a 7 days duration with 1st day discarded for mean calculation (86 %).

Results:

Specificity (Sp) fluctuated around 70 % and was the highest for a 5 (73 %) and 3 days schedule. However the 5 days schedule had higher Se (83 %) than the 3 days (76%). Proportions of KTR correctly classified according to daytime ABPM were 79 %, 79 % and 78 % with the 7, 5 or 3 days schedule, respectively.

Conclusions:

HBP, easier and less restricting method than 24 h ABPM, is a good alternative to daytime ABPM as nearly 80 % of treated KTR were similarly classified by both techniques. HBP recording period can be shortened to 5 days according to Sensitivity and Specificity. A 3 days schedule appears more risky reducing the chance to identify masked HT due to a decreased drug adherence.

Related Topics

    loading  Loading Related Articles