Morning BP surge in kidney transplant recipients tied to graft dysfunction, arterial stiffness
Turkey: A recent study revealed that in renal transplant recipients increased morning blood pressure surge is associated with graft dysfunction, LVMI, and increased arterial stiffness that could lead to cardiovascular morbidity and mortality. The study was published in the journal Clinical Transplantation on 15 June 2022.
Morning blood pressure pulse (MBPS) is defined as the rise in blood pressure before awakening in the morning. MBPS is considered an independent risk factor for cardiovascular disease.
Bahar Gurlek Demirci, Department of Nephrology, Ankara Memorial Hospital, Ankara, Turkey, and colleagues conducted the study with the objective to investigate the associations between MBPS, graft function, arterial stiffness, and echocardiographic indices in renal transplant recipients.
The study enrolled 122 patients who had a history of hypertension and were taking at least one antihypertensive medication among 600 renal transplant recipients. Carotid-femoral pulse wave velocity (PWv) was used for measuring arterial stiffness and an assessment of echocardiographic indices was done. Monitoring of 24-hour ambulatory blood pressure was done for all patients. MBPS was calculated by substracting morning systolic blood pressure from minimal asleep systolic blood pressure.
The findings of the study are as follows:
- Mean morning, daytime, and asleep systolic blood pressure values were 171.2± 23.9, 137.9± 18.1, and 131.7 ± 18.9 respectively.
- Non-dipper hypertention status was observed in 93 patients. Mean MBPS was 35.6 ± 19.5 mm Hg, and mean PWv was 6.5 ± 2.0 m/sec.
- Patients with MBPS ≥ 35 mm Hg, had significantly lower eGFR and higher proteinuria, PWv. higher left atrium volume and LVMI.
- In regression analysis, daytime systolic blood pressure, asleep systolic blood pressure, morning blood pressure surge, non-dipper status, and left ventricular mass index were detected as the predictors of graft function.
Based on the findings, the researchers conclude, "increased morning blood pressure surge is associated with graft dysfunction, increased arterial stiffness and LVMI that contributes to cardiovascular mortality and morbidity in renal transplant recipients."
Reference:
Demirci, Bahar Gurlek, et al. "Morning Blood Pressure Surge in Renal Transplant Recipients: Its Relation to Graft Function and Arterial Stiffness." Clinical Transplantation, 2022, pp. e14740.
