Comprasion of peripheral and central blood pressure with renal and cardiac target organ damages

Objective: The objective of this study is to evaluate the relation between the end-organ damage and peripheral and central aortic blood pressure in the kidney-transplanted patients followed up in the nephrology outpatient clinic of Ç.Ü.T.F. Balcalı Hospital. Materials And Methods: In this study, we measured the brachial and central aortic blood pressure of 46 follow-up patients under daytime ambulatory and office conditions in the nephrology outpatient clinic of the Ç.Ü.T.F. Balcalı Hospital. In all patients, electrocardiographic and echocardiographic findings of the left ventricle hypertrophy, albuminuria and proteinuria in spot urine samples were evaluated. The relation between blood pressure levels and end-organ damage markers were investigated. SPSS v.22.0 software program was used for the calculations of the data. Results: In kidney transplanted patients, we found that the daytime ambulatory brachial artery blood pressure was higher than the blood pressure levels in the office(in hypertensive patients: 135,6/85,6 mmHg and 121,8/77,5 mmHg; in normotensive patients: 118,8/77,6 mmHg and 101,6/62,5 mmHg). We observed that some of the patients[7(%15) patients] who were normotensive during the measurements in the office, became hypertensive with the ambulatory blood pressure measurement methods. We found also out that the central aortic systolic blood pressure was lower than the brachial artery systolic blood pressure(the average central aortic pressure:123±23 mmHg; minimum: 87,5 mmHg -maximum: 213,8 mmHg). There was a more significant correlation between the left ventricle mass index and high level of the proteinuria and central aortic systolic pressure(respectively p=0,015 r=0,358 and p=0,022 r=0,499) than the peripheral blood pressure (respectively p>0,05 and p=0,049 r=0,356). Furthermore, we determined that the left ventricle hypertrophy was less common in patients using ACEIs, although not statistically significant(p>0,05). Conclusion: Kidney-transplanted patients should be evaluated with ambulatory blood pressure measurements, even if they have normal blood pressure levels during the measurements in the office. In the hypertensive patients, the aim of the therapy is not only to decrease the brachial artery pressure. Keeping the central aortic systolic blood pressure in the proper interval adjusted according to the age, may prevent the development of the end-organ damage.