- Home and Office Blood Pressure Variability and Its Association With Cardiovascular Risk Factors in CKD Patients
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Ho Jin Lee
2025 ; 2025(1):
blood pressure variability , home blood pressure measurement , whitecoat hypertension, left ventricular hypertrophy , chronic kidney disease
- 논문분류 :
- 춘계학술대회 초록집
White coat hypertension (WCH) is more common in patients with chronic kidney disease (CKD), and both WCH and blood pressure (BP) variability are known to increase cardiovascular risk. This study aims to evaluate the difference between home and office BP, as well as the extent of BP variability in CKD patients, and to investigate their relationship with cardiovascular disease risk factors. A total of 303 adult patients currently on antihypertensive medication were enrolled in this study, which was conducted at Korea University Anam, Guro, and Ansan Hospital in 2024. Home BP measurements were recorded by patients using the HealthScan mobile application. The mean, standard deviation (SD), coefficient of variation (CV), Variability Independent of the Mean (VIM), and Average Real Variability (ARV) of SBP, as well as the mean and CV of DBP, were significantly higher in office BP than in home BP (P ≤ 0.011). The mean difference of SBP was 12.3±11.9 mmHg, and DBP was 5.1±9.0 mmHg between home and office BP. Estimated GFR was negatively associated with the variability of office BP (SD, CV, VIM, and ARV). (P ≤ 0.004). However, eGFR was not associated with home BP variability. In patients with eGFR<60 ml/min/1.73m² (CKD), the variability of office SBP (SD, CV, VIM, and ARV) was significantly higher compared to patients with eGFR≥60 ml/min/1.73m² (P≤0.037). The variability of office SBP was significantly related to diabetes, left ventricular hypertrophy (LVH), and heart failure (HF) (P<0.05). Variability of office SBP (SD, CV, and VIM) was highest in patients with both LVH and CKD, compared to those with CKD alone, LVH alone, or neither condition. Office BP was significantly higher than home BP. Office SBP variability was higher in CKD patients and was associated with DM, LVH, and HF. Office SBP variability was highest in patients with both LVH and CKD.