대한신장학회

논문분류	춘계학술대회 초록집
제목	The Optimal Time to Measure Blood Pressure as a Representative Value of 24-hour Mean Blood Pressure
저자	Jiwon Ryu1, Ran-hui Cha2, Sun Ae Yoon3, Dong Ryul Rhu4, Ji Eun Oh5, Sejoong Kim1, Sang-Youb Han6, Eun Young Lee7, Yon Su Kim8
출판정보	2013; 2013(1):
키워드	혈압, 만성콩팥병, 24시간/Blood pressure, Chronic kidney disease, 24 hours
초록	Background: Hypertension is one of treatment targets for the progression of chronic kidney disease. Average of 24 hour ambulatory blood pressure (BP) is gold standard for the measurement of high BP, which may not be a comfortable method. Optimal and representative time for the representative BP value in patients with chronic kidney disease (CKD) is still unknown. Methods: We evaluated whether there may be proper time to measure BP for predicting the average of 24 hour BP in the nationwide, multicenter, cross-sectional study (n, 1317; mean age, 57 years; men, 62.9%; diabetic nephropathy, 25.0%). Results: Regression analysis showed that systolic BP (SBP) at the 8 AM and 9 PM during the awaken period, best agreed with the 24-hr mean SBP (r=0.654, r=0.668, respectively). Agreement between SBP at 9PM and the 24 hr mean SBP in the dipper group was the highest value in the four different dipping groups, (r=0.558 in the extreme dipper group, r=0.662 in the dipper group, r=0.708 in the non-dipper group, r=0.635 in the reverse dipper group). The same Agreement in CKD 4 patients was the highest (r=0.602 in the stage 2 of CKD, r=0.645 in the stage 3 of CKD, r=0.725 in the stage 4 of CKD). That agreement in non-proteinuric patients was better than that in proteinuric patients (r=0.875 in no proteinuric patients, r=0.622 in proteinuric patients). The agreement between SBP at 9PM and 24 hr mean SBP was not different according to the presence of diabetes or left ventricular hypertrophy (LVH) (r=0.648 in non-diabetic patients, r=0.672 in diabetic patients; r=0.659 in no LVH patients, r=0.484 in probable LVH patients, r=0.665 in definite LVH patients). Conclusion: This data suggest that BP measurement at an optimal time may be probably 9 PM, especially, in the patients with non-dipper, the stage 4 of CKD, or without proteinuria in this CKD cohort. However, BP measurement at a single time cannot replace the 24 hour mean SBP In other population. This study was sponsored by sanofiaventis Korea Co. Ltd.
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