Autonomic Imbalance and 24-h Blood Pressure Change in Patients With Chronic Renal Disease

Autonomic Imbalance and 24-h Blood Pressure Change in Patients With Chronic Renal Disease

Many patients with chronic renal disease show a loss of the nocturnal decline of blood pressure (non-dipper). However, the mechanism is not yet fully understood. We evaluate 24-hour blood pressure in patients with chronic renal disease using an ambulatory blood pressure monitoring device (A & D TM2425). We also analyze the power spectrum of heart rate variability as an index of autonomic cardiovascular modulation using the same device.

The ratio of lower frequency (LF) and higher frequency (HF) heart rate rhythmic oscillations is expressed as an index of sympathovagal balance. Patients with chronic renal disease participate in the study. Blood pressure and power spectrum of heart rate variability for 24 hours are measured when they receive no medication for at least 1 week. The mean waking and sleeping time systolic and diastolic blood pressure are calculated. LF/HF ratios in the chronic renal disease are evaluated to calculate the waking/sleeping ratio for LF/HF.

Inclusion Criteria:

• Hypertensive patients with diabetes mellitus
• Hypertensive patients
• Hypertensive patients with renal disease
• Patients with chronic renal disease

Exclusion Criteria:

• Cardiac, hematologic or hepatic disease
• Cerebral infarction or hemorrhage
• Other major diseases.