HYPERTENSION IN RENAL TRANSPLANT PATIENTS: ROLE OF AMBULATORY BLOOD PRESSURE MONITORING. (June 2018) - Mars, M.
Abstract : Objective: Hypertension is a major cardiovascular risk factor associated with loss of renal graft function. Ambulatory Blood Pressure Monitoring (ABPM) is one of the methods to evaluate this factor. The objective of our study is to evaluate the different indications and the results of the ABPM performed in renal transplant patients in our center. Design and method: This is a retrospective study including ABPM performed in renal transplant recipients between January 2011 and December 2017. We reviewed the demographic, clinical, indications and outcomes of ABPM. Results: We collected a total of 59 MAPA performed for 37 patients (21 men and 16 women), with a mean age of 40 ± 10 years. A known hypertension was observed in 62% of cases. Diabetes, dyslipidemia, chronic allograft nephropathy were observed respectively in 37%; 22% and 54% of cases. The indications for ABPM were: unbalanced hypertension in consultation (54.2%), borderline hypertension (25.4%), search for masked hypertension (22%), and BP control (3, 4%). The unbalanced hyertension was confirmed in 81% of cases and white coat hypertension in 19% of cases. Among ABPM made for borderline BP, a confirmed hypertension was observed in 8% of cases, unbalanced hypertension in 58% and well-balanced hypertension in 33% of cases. The ABPM performed in search for a masked hypertension confirmed the hypertension in 77% of cases. The mean SBP and DBP in consultation were respectively 147 ± 26 mmHg and 86 ± 17 mmHg. The mean global, diurnal and nocturnal BP in ABPM were 140/84, 144/88 and 137/ 82 mmHg respectively. The majority of patients (39 MAPA) had a non-dipper and riser profile. Conclusions: ABPM has a much greater contribution than the office BP. It helps to better guide the treatment to avoid intensify or alleviate it for a better control of BP in transplant recipients.