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Blacks With Kidney Disease Should Watch for Blood Pressure Shifts: Study

Daily fluctuations in hypertension might warn of early death, researchers say

THURSDAY, March 14 (HealthDay News) -- Large day-to-day blood pressure changes in blacks with kidney disease are associated with an increased risk of premature death, a new study suggests.

The findings emphasize the importance of routine blood pressure checks in kidney disease patients and also suggest that treatments for large blood pressure fluctuations may improve patients' health, according to Dr. Ciaran McMullan of Brigham and Women's Hospital in Boston and colleagues.

Blacks are more likely than whites to develop kidney disease. It's difficult for doctors to predict which black patients with kidney disease have the highest risk of premature death. But it is known that cardiovascular disease is the most common cause of death in kidney disease patients and that there is a strong link between blood pressure and kidney disease progression.

This study included 908 black adults who had kidney disease because of high blood pressure. The patients had at least one year of blood pressure measurements available and were followed for between three and 6.4 years.

Patients with significant day-to-day blood pressure changes were nearly three times more likely to die from any cause and nearly six times more likely to die from heart problems than those whose blood pressure was more stable, according to the study, published online March 14 in the Clinical Journal of the American Society of Nephrology.

"Larger changes in blood pressure from day to day could identify a high-risk group of African Americans with kidney disease," McMullan said in a news release from the American Society of Nephrology. "In addition, it means that scientists should examine why people have large day-to-day variations in blood pressure, as this may turn out to be a new area of therapy research."

The findings "mean that doctors should start paying attention not only to what the blood pressure is on the day you see him or her, but also on whether it is changing a lot each time he or she sees you," McMullan added.

While the study found an association between blood pressure fluctuations and premature death in black kidney disease patients, it did not prove a cause-and-effect relationship.

More information

The U.S. National Kidney Disease Education Program has more about kidney disease.


SOURCE: American Society of Nephrology, news release, March 14, 2013

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