NEW YORK (Reuters Health) - A measure of blood pressure that reflects artery stiffness may be a better indicator of death risk in patients with advanced kidney disease than traditional blood pressure measures, new research suggests.

In the general population, high blood pressure is a major risk factor for serious conditions such as heart disease, stroke and kidney disease. Blood pressure is considered high when systolic pressure--the first number in a blood pressure reading--is above 140 mm Hg, and diastolic pressure--the second number in the reading--goes over 90 mm Hg.

But a different, "counterintuitive" pattern has emerged in patients with end-stage kidney disease being maintained on dialysis, according to the authors of the new study. In these patients, elevated systolic blood pressure has been linked to a lower risk of death.

Recent research in individuals without end-stage kidney disease has linked the risk of heart failure, heart attack and death to increases in pulse pressure--a measure of systolic pressure minus diastolic pressure.

In the new study, researchers found that similarly, elevated pulse pressure was related to a higher risk of death in kidney patients being maintained on hemodialysis. Each increaseof 10 mm Hg in pulse pressure corresponded to a 12% increase in patients' risk of death over one year,according to researchers led by Dr.Preston S. Klassen of Duke University Medical Center in Durham, NorthCarolina.

This relationship, Klassen's team reports, was mainly seen in patients with systolic pressure below 140. Itappears, according to the researchers, that for any given increase insystolic pressure, the lower the diastolic pressure, the higher the death risk.

The findings suggest that pulse pressure could help identify patients with end-stage kidney disease who areat particularly high risk of death, the investigators report in theMarch 27th issue of The Journal of theAmerican Medical Association.

According to the researchers, pulse pressure reflects stiffness in the arteries and other aspects of bloodvessel function that may be particularly important when heart dysfunction is present--as is often the case withend-stage kidney disease.

They call for further research into whether diet changes and drug therapy can aid blood vessel functioning in these patients, and whether doing so improves their prognosis.

The findings are based on more than 31,000 dialysis patients across the US who were followed for one year.Overall, 18% of the patients died.

SOURCE: The Journal of the American Medical Association2002;287:1548-

Reference Source 89

For more information on how to prevent other diseases, use
PreventDisease.com's "Quick Prevention Resources".