Blood Pressure Measurements and Left Ventricular Mass Index in Hemodialysis Patients

Left ventricular hypertrophy (LVH) is the most frequent cardiac abnormality in hemodialysis (HD) patients. It is related to cardiovascular diseases and is an important risk factor for mortality in HD patients. Arterial hypertension is an established risk factor for LVH in HD patients. Inferior vena cava (IVC) diameter is a good indicator of circulating fluid volume; hypervolemia is an important pathogenetic factor of hypertension in HD patients. The purpose of our study was to evaluate possible association between LVH, IVC diameter, and different blood pressure (BP) measurements in HD patients. In the present study, 85 HD patients were included. BP was measured with a standard mercury sphygmomanometer before and after the HD session; the average 1-monthly values of the routine BP measurements were also analyzed. 24- and 48-h ambulatory blood pressure measurements (ABPMs) were performed after the end of HD sessions using a noninvasive ABPM. Average values of systolic and diastolic BP were analyzed separately for the first (HD) and second (interdialytic) day ABPM and for both days together. Using echocardiography, left ventricular mass was measured and left ventricular mass index (LVMI) was calculated. Using ultrasonography, IVC diameter was measured on the interdialytic day. Using multiple regression analysis, we found statistically significant correlations between LVMI and mean monthly postdialysis systolic BP (P < 0.05) and mean 48-h diastolic BP (P < 0.05). Only longer BP measurements (average 1-month post-HD and 48-h ABPM) were associated with LVMI in HD patients.