Weekly Home BP Monitoring Enhances Hypertension Detection in Hemodialysis Patients: Study Finds

"HBPM demonstrated greater diagnostic accuracy than 44-hour ambulatory BP monitoring (AUC: 0.934). With a threshold of 141.0 mmHg, HBPM achieved optimal sensitivity (85.7%) and specificity (92.9%), reinforcing its value as a reliable screening tool for this patient population," the researchers reported in the Journal of Human Hypertension.

The best approach for diagnosing hypertension in hemodialysis patients remains a subject of debate. To address this, Panagiotis I. Georgianos, 2nd Department of Nephrology, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, and colleagues evaluated the accuracy of home blood pressure monitoring and routine dialysis-unit BP recordings, using 44-hour ambulatory BP monitoring (ABPM) as the reference standard.

For this purpose, the researchers assessed hypertension over two weeks using three methods: (i) routine predialysis and post dialysis BP recordings averaged over six consecutive dialysis sessions, (ii) home BP monitoring (HBPM) for seven days with duplicate morning and evening measurements (Microlife WatchBP Home N), and (iii) 44-hour ambulatory BP monitoring (ABPM) with 20-minute intervals over an entire interdialytic period (Microlife WatchBPO3). The study included 70 patients (mean age: 65.3 ± 13.2 years), 87.1% receiving hypertension treatment, and an average 44-hour ambulatory systolic/diastolic BP of 120.6 ± 15.2/66.3 ± 10.1 mmHg.

Based on the study, the researchers reported the following findings:

• The mean difference between ambulatory daytime systolic BP (SBP) and routine BP measurements was:
  • Predialysis SBP: -11.4 ± 13.4 mmHg
  • Postdialysis SBP: -4.0 ± 15.1 mmHg
  • Home SBP: -8.6 ± 10.7 mmHg
• Home BP monitoring (HBPM) showed superior diagnostic performance for detecting ambulatory daytime SBP ≥135 mmHg:
  • Home SBP: AUC 0.934
  • Predialysis SBP: AUC 0.778
  • Postdialysis SBP: AUC 0.766
  • HBPM was significantly more accurate than both predialysis and postdialysis SBP (P = 0.02).
• At a cut-off of 141.0 mmHg, home SBP provided the best balance of sensitivity (85.7%) and specificity (92.9%) for diagnosing hypertension.

The study findings highlight that in hemodialysis patients, home blood pressure monitoring conducted over a week is more reliable than routine dialysis-unit BP recordings averaged over two weeks in detecting ambulatory hypertension. HBPM demonstrated greater accuracy in identifying elevated blood pressure levels, making it a valuable tool for improving hypertension diagnosis in this population.

"These results suggest that integrating HBPM into routine clinical practice could enhance blood pressure management, leading to better cardiovascular outcomes for hemodialysis patients," the authors concluded.

Reference:

Leonidou, K., Georgianos, P. I., Kollias, A., Kontogiorgos, I., Vaios, V., Leivaditis, K., Karligkiotis, A., Stamellou, E., Balaskas, E. V., Stergiou, G. S., & Liakopoulos, V. (2025). Home versus routine dialysis-unit blood pressure recordings among patients on hemodialysis. Journal of Human Hypertension, 1-7. https://doi.org/10.1038/s41371-025-01007-7