Abstract: SA-PO0512
Utility of Simultaneous Measurement of 24-Hour Ambulatory Brachial and Central Blood Pressure in CKD
Session Information
- CKD: Clinical - Therapies, CKM Health, Special Populations, and More
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Narkhede, Mrunal, Bombay Hospital and Medical Research Centre, Mumbai, MH, India
- Shah, Kriya Hardik, University of Nottingham, Nottingham, England, United Kingdom
- Shah, Hardik Kirit, Bombay Hospital and Medical Research Centre, Mumbai, MH, India
- Kirpalani, Dilip, Bombay Hospital and Medical Research Centre, Mumbai, MH, India
- Kirpalani, Ashok, Bombay Hospital and Medical Research Centre, Mumbai, MH, India
Background
CKD is associated with progressive arterial stiffening and augmented central arterial pressure, leading to elevated central blood pressure (CSBP) that cannot be detected by brachial BP(BSBP) measurements. Delta (δ= BSBP-CSBP; a marker of arterial stiffness) in healthy state is typically between 10-14 mmHg but tends to be lower in CKD due to higher CSBP.Our study aims to evaluate the effect of various antihypertensive agents and assess the clinical utility of a novel device (OSCAR 2) that simultaneously measures both 24 hour Brachial and Central BP (CABPM).
Methods
50 consecutive hypertensive CKD outpatients(pts) underwent CABPM. Clinical and treatment related data collected and readings analysed.
Results
M/F=32/18; CKD Stage G1-1, G2-10, G3-11, G4-12, G5ND-4, G5D-8, G5T-4 pts; Mean age:46.6+13.4 yrs. CABPM pattern, Pulse Pressure Amplification (PPA); Corrected Augmentation Index@Hr 75 (CAIx) and Ambulatory Arterial Stiffness Index (AASI) were analysed across subgroups.
Pts(n=22) with 24hr BSBP within “target” (<130 mmHg) had δ- 8.5, PPA-1.07, CAIx-31.3, AASI-0.43. Table 1 shows analysis of 41/50 pts on dual therapy {combination of calcium channel blockers (CCB) /Betablockers (βB)/Central Sympatholytics (CSA)}. Using ANOVA (Tukey HSD test), pts on CCB had significantly higher delta & PPA, lower CAIx and AASI as compared to those not on CCB (Gr 1 vs Gr 3, p<0.05; Gr 2 v Gr 3, p<0.05; whereas Gr 1 vs Gr 2, p>0.05).
In Gr 3, vasodilatory βB (n=5) had higher δ (9.1 vs 7.2), lower CAIx (31.2 vs 33.1) and AASI (0.43 vs 0.52) than the non-vasodilatory βB (n=5); but p>0.05.
Conclusion
In 44% pts, central arterial stiffness indices were significantly higher even though they had well controlled BSBP. CCB are more effective in lowering central blood pressure as compared to βB and CSA. For vasodilatory βB, perhaps a similar conclusion may be possible with a larger cohort. Simultaneous measurement of Brachial and Central Blood pressure along with indices of arterial stiffness provides clinically relevant data to finetune the management of hypertension in CKD.
Comparison of CABPM parameters
| Group | Anti-Hypertensive regimen | Nos. | Mean 24h BSBP | Mean 24h CSBP | Delta(BSBP-CSBP) | PPA | CAIx | AASI |
| Gr 1 | CCB+CSA | 15 | 142.7 ± 15.6 | 130.8 ± 14.7 | 11.9 ± 3.3 | 1.09 ± 0.02 | 28.2 ± 9.6 | 0.34 ± 0.12 |
| Gr 2 | CCB+BB | 11 | 138.9 ± 24.6 | 127.1 ± 23.4 | 11.8 ± 3.7 | 1.09 ± 0.03 | 36.5 ± 7.3 | 0.52 ± 0.14 |
| Gr 3 | BB+CSA | 10 | 143.4 ± 20.6 | 134.7 ± 20.3 | 8.7 ± 2.2 | 1.06 ± 0.01 | 28.1 ± 9.1 | 0.41 ± 0.21 |