LAUSR

Objective: Several studies have demonstrated that increased blood pressure (BP) variability is associated with target-organ damage development in hypertensive patients. However, the impact of short-term BP variability indices on target-organ damage in chronic kidney disease patients (CKD) is unclear. Aim of the study was to evaluate the association between ambulatory BP variability indices and common carotid artery intima-media thickness (CCA-IMT) in chronic kidney disease patients. Design and method: A total of 83 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent 24-h ambulatory blood pressure (BP) monitoring and CCA-IMT ultrasonographic measurements. Short-term BP variability was expressed by standard deviation (SD), time rate of BP variation (TR), average real variability (ARV) and coefficient of variation (CV) of systolic and diastolic BP for both 24-h, daytime and nighttime intervals. Statistical analysis was performed by means of bivariate correlations, simple and multiple linear regression analysis. Results: The study population consisted of 65 men (78%) and 18 women (22%). All diastolic BP variability indices did not correlated significantly with CCA-IMT. In contrast, 24-h systolic SD (r = 0.429, p < 0.001), TR (r = 0.576, p < 0.001), ARV (r = 0.537, p < 0.001) and CV (r = 0.309, p = 0.004) significantly correlated with CCA-IMT. The multivariate analysis revealed (ARV was excluded due to collinearity reasons) that 24-h systolic TR of BP variation was the only variable that was significantly and independently associated with CCA-IMT (B = 0.702, 95%CI 0.377–1.027, p < 0.001). The association remained significant after adjustment for baseline characteristics and risk factors. Conclusions: Systolic ambulatory BP variability indices such as SD, TR, ARV and CV are associated with CCA-IMT in CKD patients. The systolic TR of BP variation is better associated with CCA-IMT than the other indices in CKD patients.