Nocturnal high blood pressure and left ventricular hypertrophy in patients with chronic kidney disease

Background: Patients diagnosed with chronic kidney disease (CKD) have a heightened risk of developing masked uncontrolled hypertension (MUCH), leading to hypertension-induced organ damage. This study aimed to estimate the prevalence and characteristics of MUCH and to investigate risk factors of left ventricular hypertrophy (LVH) in those with CKD. Methods: A retrospective study was conducted on data from 178 patients diagnosed with CKD and having controlled office blood pressure at Nhan Dan Gia Dinh Hospital between October 2018 and June 2019. These participants underwent 24-hour ambulatory blood pressure monitoring (ABPM) using the SunTech Oscar 2 device. Subsequently, echocardiography was performed to assess for the presence of LVH. Results: The prevalence of MUCH was 48.9%. Notably, all patients with MUCH demonstrated elevated nighttime blood pressure. LVH was more prevalent in the MUCH group when compared to those with controlled hypertension (55.2% and 38.5%, respectively). MUCH and CKD staging 4-5 were independent risk factors of LVH with ORs 1.97 (95% CI, 1.03-3.85) and 2.58 (95% CI, 1.16-5.94), respectively. Conclusions: We recommend routinely using ABPM to detect MUCH in CKD patients even with controlled office hypertension. Screening for LVH is necessary in those with MUCH.