Forty-Eight-Hour Ambulatory Blood Pressure and Carotid-Femoral Pulse Wave Velocity in Hemodialysis Patients

Carotid-femoral pulse wave velocity (cfPWV) is an important predictor of cardiovascular events in the general population and also in hemodialysis (HD) patients. In the general population, cfPWV is strongly associated with age and blood pressure (BP). The best timing and method of BP measurement in HD patients is uncertain. Ambulatory blood pressure measurements (ABPM) have been used to better define the relationship between BP, target organ damage, and outcomes in HD patients. The aim of this study was to determine the possible association between cfPWV, cardiovascular risk factors, single BP measurements, and 48-hour ABPM in chronic HD patients. Thirty-three HD patients (22 men, 11 women) were included. After the end of the mid-week HD session, BP was measured, arterial stiffness was estimated by cfPWV, and 48-hour ABPM was performed. The mean systolic and diastolic BP readings before cfPWV measurement were 136/79 mm Hg, and the mean 48-hour systolic and diastolic BP readings were 131/76 mm Hg. The mean and range of the cfPWV measurements were 8.31 +/- 2.35 m/s and 5.18-16.53 m/s, respectively. Using regression analysis, no association between cfPWV and BP before PWV measurements was found. A statistically significant correlation between cfPWV and 48-hour systolic and diastolic ABPM was found. Using multiple regression analysis (including age, sex, smoking, diabetes, body mass index, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, C-reactive protein, albumin, phosphorus, calcium, and iPTH) 48-hour systolic (P < 0.001) and diastolic ABPM (P < 0.005) still remain significantly associated with cfPWV. Only 48-hour ABPM was associated with cfPWV in HD patients in our study. We found no relationship between cfPWV and other cardiovascular risk factors.