Original scientific paper

Inappropriate opinion on normal blood pressure and impact on compliance in chronic hemodialysis

DIJANA ŠPEH ; Medical School Osijek, University J.J. Strossmayer Osijek, Osijek, Croatia
TIJANA PANDUROVIĆ orcid.org/0000-0002-6670-804X ; Medical School Osijek, University J.J. Strossmayer Osijek, Osijek, Croatia
LADA ZIBAR ; Medical School Osijek, University J.J. Strossmayer Osijek, Osijek, Croatia
SANJA STIPANIĆ ; University Hospital Centre Osijek, Osijek, Croatia

Abstract

Background: Arterial hypertension (AH) associated with cardiovascular disease is often responsible for morbidity andmortality in chronic hemodialysed patients (CHD). Noncompliance with antihypertensives could be related to distorted view on normal blood pressure (NBP).

Purpose: To examine if CHD patients consider increased blood pressure (BP) for normal and consequently have poor compliance with antihypertensive therapy.

Patients and Methods: 202 CHD patients (aged 25–85 years) at University
Hospital Centr Osijek, Croatia, completed a questionnaire onmaximal
NBP, compliance to antihypertensives and symptoms related to BP
variations. Data on medical history and AH control were obtained from their medical records. Optimal BP before hemodialysis (HD) session was considered <140/90 mmHg, mean arterial pressure (MAP) <107 mmHg, corresponding to the high normal BP according to guidelines ESH-ESC 2007.

Result: 57% of 202 patients declared maximum acceptable systolic BP
>139 mmHg (median 150, range 140–180). Majority of them would not take antihypertensives and reported symptoms accurring by BP lower than preferred. The year of AH diagnosis differed significantly from the initial year of antihypertensive therapy (P<0.001), indicating delayed treatment.

Patients with distorted view on NBP were older (P=0.012), took more
antihypertensives (P=0.043) and had higher predialysis MAP (P=0.019) in comparison with other patients.

Conclusion: CHD patients consider NBP to be higher than officially
recommended. Majority had poorly regulated AH due to noncompliance with antihypertensives therapy. Different view on NBP could be attributed to their symptoms occurring by BP lower than preferred. They seem to be adapted to increased BP. The question remains whether this is a consequence of delayed AH treatment or inadequate guidelines for CHD patients.

Keywords

arterial hypertension; compliance; antihypertensive treatment; dialysis

Hrčak ID:

74122

URI

https://hrcak.srce.hr/74122

Publication date:

31.10.2011.

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