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Nephrol Dial Transplant (2002) 17: 1737-1741
© 2002 European Renal Association-European Dialysis and Transplant Association

Invited Comment

Ambulatory blood pressure monitoring: an essential tool for blood pressure assessment in uraemic patients

Adrian Covic1, and David Goldsmith2

1 Renal Unit, Parhon Hospital, Iasi, Romania and 2 Department of Nephrology, Guy's Hospital, London, UK

Keywords: ambulatory blood pressure monitoring; blood pressure circadian variability; diurnal blood pressure; non-dipping; uraemia

The first 150 words of the full text of this article appear below.

Introduction

Ambulatory blood pressure monitoring (ABPM) has been growing steadily in popularity, as equipment becomes more portable, accurate and affordable, software packages more powerful, and physicians more accepting of its advantages (see Table 1Go). However, the most recent guidelines from National and International Hypertension Societies only advocate its use in ‘difficult’ cases (Table 2Go) [1]. This conservatism sits uncomfortably alongside the repeated observation that up to one in four so-called hypertensive patients have normal ambulatory BP levels away from the clinical setting [2].


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  		Table 1.  Clinical indications for the use of ABPM

 

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  		Table 2.  Recommended utilization of ABPM from WHO–ISH [1]

 
From the early use of direct intra-arterial blood pressure (BP) recordings, the beat-to-beat, minute-to-minute variability of BP has been appreciated [3]. Diurnal BP variation has been studied intensively for several decades. Diurnal BP normally falls with sleep; this behaviour is normally distributed in normotensive . . . [Full Text of this Article]

Recent prospective trials examining the predictive power of ABPM

ABP levels
ABP circadian variability
Conclusions


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