AMBULATORY BLOOD-PRESSURE IN HYPERTENSIVE PATIENTS WITH AUTOSOMAL-DOMINANT POLYCYSTIC KIDNEY-DISEASE

Background. Ambulatory blood pressure is more closely correlated with various indices of hypertensive target-organ damage, and is a better p rognostic predictor of cardiovascular morbidity and mortality than con ventional methods of blood pressure measurement. Autosomal dominant po lycystic kidney disease (ADPKD) is complicated by hypertension, progre ssive renal failure, and an increased risk of cardiovascular mortality . This study investigated the 24-h ambulatory blood pressure profile i n patients with ADPKD in view of the sparsity of such data in these pa tients and the possibility that abnormal diurnal blood pressure variat ions may have prognostic consequences. Methods. Ambulatory blood press ure was measured over a 24-h period by the oscillometric method with a n automatic non-invasive recorder (SpaceLabs 90207 system) in matched groups of 25 hypertensive patients with ADPKD and 25 patients with ess ential hypertension. Results. Both groups showed a nocturnal decrease in blood pressure, but this was significantly smaller in patients with ADPKD. There was no evidence of enhanced lability of blood pressure i n ADPKD. Conclusions. The nocturnal fall in blood pressure was attenua ted in patients with ADPKD. Further studies are required to assess the importance of this finding and its possible contribution to the progr ession of renal failure or increased cardiovascular mortality in these patients.