%0 Journal Article
%T Home and Office Blood Pressure Monitoring in Renal Transplant Recipients
%A Rebecca Sberro-Soussan
%A Marion Rabant
%A Renaud Snanoudj
%A Julien Zuber
%A Lynda Bererhi
%A Marie-France Mamzer
%A Christophe Legendre
%A Eric Thervet
%J Journal of Transplantation
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/702316
%X Background. Arterial hypertension in renal transplant recipients (RTR) is associated with increased morbid mortality. In the general population, home blood pressure monitoring (HBPM) was found to be superior to office blood pressure (OBP) in identifying true hypertensive patients. The aim of this study was to investigate HBPM for the assessment of blood pressure profile in RTR. Methodology and Principal Findings. We included prospectively 87 stable RTR. Sitting OBP was measured during the outpatient clinic. HBPM was performed by measuring BP every morning and night for 4 days. The accepted limits for the OBP and HBPM, were respectively, 140/90£¿mmHg and 135/85£¿mmHg. Patients were classified as ¡°normotensive,¡± ¡°uncontrolled,¡± ¡°white-coat hypertensive¡± and ¡°masked hypertensive¡±, (OBP below the limit and HBPM above). During the study, 81 patients (55 males, age 4 8 . 5 ¡À 1 4 years) were available for analysis. The mean OBP and HBP were 1 3 8 / 8 3 ¡À 1 4 / 1 0 £¿mmHg and 1 3 3 / 7 9 ¡À 1 4 / 8 £¿mmHg; 29% of patients were uncontrolled, 28% normotensive, 21% white coat, and 21% masked hypertensive. Age, glycemia, and number of antihypertensive drugs were associated with hypertension. Conclusion and Significance. In RTR, HBPM is well accepted and better define BP profile since there is 42% discrepancy between OBPM and HBPM. Whether this discrepancy is associated with worst outcome in the long term remains to be demonstrated. 1. Introduction Arterial hypertension is prevalent in renal transplant recipients (RTR) and is a powerful predictor of impaired graft and patient outcome [1]. Diagnosis of arterial hypertension has traditionally been based on measurements of blood pressure (BP) in the office or clinic. However, it is known for many years that BP, in most individuals, is higher in this setting than in home. It is now well recognized that out-of-office recordings of BP yield better prognostic information than those obtained in physician¡¯s offices [2¨C4]. A recent review has emphasized the advances of out-of-office recordings in patients with chronic kidney disease [5]. Home measurements can be obtained either by ambulatory BP monitoring or self-measurement of BP. Both these techniques allow detecting white-coat hypertension and masked hypertension. White-coat hypertension is defined as well-controlled home hypertension but poorly controlled clinic hypertension. Masked hypertension is the reverse phenomenon, poorly controlled BP at home, but normal in the clinic [6]. Furthermore, ambulatory BP monitoring gives more measurements and may identify the variability of
%U http://www.hindawi.com/journals/jtrans/2012/702316/