P-432: Metabolic determinants of pulse pressure in hemodialysis patients

• Published in: American journal of hypertension 2004-05, Vol.17 (S1), p.192A-192A
• Main Authors: Kahraman, Serkan, Arici, Mustafa, Genctoy, Gultekin, Yilmaz, Rahmi, Altun, Bulent, Kirkpantur, Alper, Yasavul, Unal, Caglar, Sali
• Format: Article
• Language: English
• Subjects: Calcium and Phosphate; Hemodialysis; Pulse Pressure
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1016/j.amjhyper.2004.03.506

Pulse pressure is an index of the pulsatile component of the cardiac cycle. The reduction in distensibility of major arteries leads to increased pulse pressure. However, beyond the hemodynamic factors, underlying mechanisms contributing to elevated pulse pressure in hemodialysis (HD) patients are yet to be defined. A total of 121 patients (50 female, 71 male, mean age: 49±30 years) on maintenance HD were included to the study. Spacelabs 90207 automatic cuff-oscillometric devices were used for 24-hour ambulatory blood pressure monitoring to assess pulse pressure. We performed multiple linear regression analysis between pulse pressure and clinical, demographic and laboratory findings of patients. It was found that body mass index, serum phosphorus and lipoprotein (a) levels, serum calcium and phosphorus product (Ca × P) and intima media thickness of carotid artery were significant predictors of pulse pressure. There is not a considerable relation between pulse pressure and gender, age, type of heparin used, smoking, serum levels of total cholesterol, LDL-cholesterol, HDL- cholesterol, albumin, C-reactive protein, soluble adhesion molecules (sP-selectin, sE- selectin, ICAM and VICAM), homocysteine and prealbumin. Elevated serum phosphorus level and Ca × P product may have impact on increased pulse pressure in HD patients as a result of arterial calcification leading to loss of arterial compliance in large arteries. Atherosclerosis and lipoprotein (a) may also modulate the development of stiffening in major arteries. Morover it is suggested that the relationship between pulse pressure and atherosclerosis is bi-directional. Although it is not possible yet to define primary event of this vicious cycle, prevention of possible factors leading to elevated pulse pressure may result in better outcome. Am J Hypertens (2004) 17, 192A–192A; doi: 10.1016/j.amjhyper.2004.03.506