[Impact of day-to-day arterial pressure variability on the left ventricle geometry in patients with predialysis chronic kidney insufficiency].

Aim: To estimate the impact of day-to-day variability of blood pressure (BP) on left ventricular geometry in pre-dialysis patients.

Material And Methods: We estimate the impact of day-to-day variability of BP on left ventricular geometry in 42 non-diabetic pre-dialysis patients (22 F, 20 M, mean age 47 +/- 12 years) with arterial hypertension (> 140 and 90 mm Hg). Serum creatinine was 286.2 +/- 176.8 micromol/l. BP was measured in the morning during 12 days and M +/- SD and delta systolic blood pressure (dSBP = SBPmax - SBPmin) was calculated. Echocardiography was performed and left ventricular mass index and relative wall thickness (RWT) was estimated.

Results: LVH was detected in 35(83.3%) patients. Multiple stepwise regression analysis revealed that mean SBP is a stronger predictor of LVH than clinical SBP (R2 = 0.59; p = 0.000001 and R2 = 0.35; p = 0.0007, resp.). Standard deviation of mean SBP correlated with RWT (R2 = 0.30; p = 0.006). dSBP > 30 mmHg was associated with an increase of RWT.

Conclusion: Mean SBP during 12 days is a stronger predictor of LVH than clinical SBP. Day-to-day variability of SBP with dSBP > 30 mm Hg was associated with development of concentric LVH.