Russian Heart Failure Journal 2011year Violation of circadian rhythm of blood pressure in patients with chronic heart failure associated with impaired renal function

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Violation of circadian rhythm of blood pressure in patients with chronic heart failure associated with impaired renal function

Serov V. A., Shutov A. M., Troshenkina O. V., Menzorov M. V., Kirischeva E. K.

Keywords: renal failure, CHF, circadian rhythm of blood pressure

DOI: 10.18087/rhfj.2011.1.1408

Background. The lack of nocturnal blood pressure reduction leads to increased pressure load, and contributes to progressive lesion of cardiovascular system and kidneys. Despite the frequent combination of CHF and chronic kidney disease (CKD), main features of circadian rhythm in such patients are still poorly understood. Objective. To study circadian BP profile in patients with CHF, depending on renal function. Materials and methods. The study included 126 patients with CHF. 60 patients had glomerular filtration rate (GFR) above 60 ml / min / 1.73 m2 (group 1), 40 patients – moderate decrease (GFR from 45 to 59 ml / min / 1.73 m2 – group 2), 26 patients – severe decrease (below 45 ml / min / 1.73 m2 – group 3). Results. 50 % of patients in 1st group had nocturnal decrease (ND) of SBP ≥10 %, in 2nd group this figure was 47.5 %, in 3d group – 19.2 % (χ2=5.9, p=0.02 for groups 1 and 3; χ2=4.3, p=0.04 for groups 2 and 3). Circadian profile of DBP also had significant differences: 65 % of patients in 1st group had ND of DBP ≥10 %, in 2nd group this figure was 60 %, in 3d – 38.5 % (χ2=4.2, p=0.04 for groups 1 and 3; χ2=2.1, p=0.1 for groups 2 and 3). Correlation of SBP and DBP ND with GFR was revealed (r=0.21, p=0.02 and r=0.23, p=0.009 respectively). Multivariate regression analysis confirmed an independent relationship between reduced GFR below 45 ml / min / 1.73 m2 and SBP and DBP ND (p=0.02 and p=0.04 respectively). The study showed significant circadian rhythm disorders in patients with CHF associated with CKD.
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Serov V.A., Shutov A.M., Troshenkina O.V. et al. Violation of circadian rhythm of blood pressure in patients with chronic heart failure associated with impaired renal function. Russian Heart Failure Journal. 2011;12(1):11-14.

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