INFLUENCE OF NYCTHEMERAL BLOOD-PRESSURE PATTERN IN TREATED HYPERTENSIVE PATIENTS ON HEMODIALYSIS

Arterial hypertension in end-stage renal disease (ESRD) patients is ch aracterized by an altered nycthemeral blood pressure (BP) rhythm and a n increased pulse pressure, and it could be suggested that this associ ation of risk factors plays a major role in the cardiovascular prognos is of this population. The aim of this study was to determine the infl uence of nycthemeral BP pattern on arterial distensibility and pulsati le components of BP in treated hypertensive patients on regular hemodi alysis. Forty-two hypertensive patients were included, and all underwe nt ambulatory BP and pulse wave velocity (PWV) measurements between th e femoral and carotid arteries. The patients were divided into two gro ups according to the magnitude of the nocturnal fall in BP: dippers an d non-dippers. The groups were similar in gender, age, duration of hem odialysis, body mass index, body size, history of cardiovascular compl ications, class and number of antihypertensive drugs used per patient. PWV was significantly higher in non-dippers. For the whole population , a stepwise regression analysis showed that PWV and eryrhropoietin th erapy were independently related to the impaired nycthemeral BP patter n. In addition to its presser effect, erythropoietin could have a dele terious influence on the ambulatory BP profile of treated hypertensive patients in ESRD. Arterial distensibility and nycthemeral BP impairme nt are linked, and these cardiovascular risk factors should be taken i nto account together for the management of hypertensive hemodialysis p atients.