Risk factors for hypertension in chronic hemodialysis patients: Baseline data from the HEMO Study

A Gross-sectional analysis was performed to determine risk factors associat ed with hypertension in 1,238 chronic hemodialysis patients upon enrollment into the HEMO Study. The mean pre- and post-dialysis systolic blood pressu re were 152.4 +/- 25.0 (mean +/- SD) and 137.8 +/- 24.6 mm Hg, respectively . The mean pre- and post-dialysis, diastolic blood pressures were 82.1 +/- 14.8 and 74.7 +/- 13.8 mm Hg, respectively. Less than 30% of the study coho rt had blood pressures that were normotensive by JNC VI guidelines. Risk fa ctors associated with higher pre- and post-dialysis systolic blood pressure s included the presence of diabetes mellitus, older age, increased number o f prescribed antihypertensive medications, lower hematrocrit, and absence o f arrhythmias. Variables associated with higher pre- and post-dialysis dias tolic blood pressures included younger age, increased number of prescribed anti-hypertensive medications and absence of arrhythmias. There was also a nonlinear relationship between blood pressure and prescribed total ultrafil tration volume. A total ultrafiltration volume of >2.5 kg was associated wi th an elevation in pre-dialysis systolic and diastolic blood pressures. A t otal ultrafiltration volume of less than or equal to2.5 kg was associated w ith an elevation in post-dialysis systolic and diastolic blood pressures. T hese data on ultrafiltration volume suggest that higher pre-dialysis blood pressures may be associated with excessive interdialytic weight gains due t o patient noncompliance with fluid restriction and that higher postdialysis blood pressures may be associated with a prescribed dry weight that is hig her than the patients true dry weight. Better management of these parameter s may improve the prevalence and severity of hypertension in this populatio n. Copyright (C) 2001 S. Karger AG, Basel.