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Abstract: FR-PO0376

Self-Measured, Clinical, and Standardized Blood Pressure Differences Among Veterans with CKD

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Maggio, Tyler, University of Iowa Health Care, Iowa City, Iowa, United States
  • Akbari, Sadaf, University of Iowa Health Care, Iowa City, Iowa, United States
  • Shi, Qianyi, University of Iowa Health Care, Iowa City, Iowa, United States
  • Geasland, Katharine M., University of Iowa Health Care, Iowa City, Iowa, United States
  • Cohen, Jordana B., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Sarrazin, Mary Vaughan, University of Iowa Health Care, Iowa City, Iowa, United States
  • Jalal, Diana I., University of Iowa Health Care, Iowa City, Iowa, United States
Background

Hypertension is a prevalent, modifiable risk factor for cardiovascular and kidney disease progression in chronic kidney disease (CKD) patients. Self-measured blood pressure monitoring (SMBP) facilitates blood pressure (BP) management, but limited data exist on SMBP uptake and comparison to clinic BP in CKD patients. Here, we compared SMBP to standardized office and clinical BP values.

Methods

We used data from an ongoing clinical trial (NCT05546099), in which Veterans with CKD are randomized to either SMBP monitoring or SMBP monitoring and self-management of BP medications. SMBP, clinical values (from the medical record), and standardized office BP values were compared over time using hierarchical models to account for repeated measures within patients. Patient recollection and compliance were assessed with qualitative interviews. Standardized BP was measured as per current KDOQI guidelines.

Results

66 Veterans had BP values including SMBP, clinical BP, and standardized BP. The cohort was predominantly white, elderly males and included 82% with CKD3a or worse. Qualitative interview responses revealed excellent recollection and compliance with home measurement instructions. Mean baseline clinical and standardized BP systolic values were 139±21.4 and 152±15.6 respectively with mean baseline diastolic BP values of 73±8.5 and 80±8.8. Mean baseline SMBP values were lower at 128±18.4 systolic and 71±11.0 diastolic. The average systolic SMBP remained significantly lower through 12 months of monitoring (approximately 20 mm Hg lower than standardized and 10 mm Hg lower than clinic values, p<0.001; Figure 1).

Conclusion

In this cohort of Veterans with CKD, SMBP was significantly lower than both clinic and standardized values. This data suggests that using SMBP for medication titration in CKD patients could lead to less intensive antihypertensive titration.

Figure 1: Systolic BP by Modality over Time

Funding

  • Veterans Affairs Support

Digital Object Identifier (DOI)