Medical Research: What is the background for this study? What are the main findings?
Dr. Quiroga: Chronic kidney disease patients are at high-risk for the development of cardiovascular events. Although several strategies have been tried for identifying those patients with poorer prognosis, no one has demonstrated by itself being the best one. This could be explained by the fact that several factors are implied in the cardiovascular profile of chronic kidney disease patients.
With this background, in our study we hypothesized if differences in the interarm systolic blood pressure could detect patients with enhanced cardiovascular risk early, and, consequently therapies could be initiated.
Our results provide interesting data on this regard, as we have concluded that an interarm systolic blood pressure difference higher that 10 mmHg is an independent prognosis factor for cardiovascular events.
Medical Research: What should clinicians and patients take away from your report?
Dr. Quiroga: The first thing clinicians and patients must have in their mind is that chronic kidney disease in a cardiovascular risk factor per se, so they should be controlled more frequently. A multifactorial approach for stratifying the risk of the patients can promote the development of new strategies for improving the poor cardiovascular profile. We propose an easy, cheap and feasible method, measuring blood pressure in both arms. If a difference higher than 10 mmHg is found, the clinician must deeply study the cardiovascular profile of these patients, as, for example, controlling the classical cardiovascular risk factors. In addition, those chronic kidney disease patients with diabetes or history of cardiovascular disease that show an interarm systolic blood pressure difference > 10 mmHg, are even at higher risk.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Quiroga: The next step is checking if interventional treatments for improving the enhanced cardiovascular risk in chronic kidney disease patients decreases their interarm systolic blood pressure difference, and establish this marker in clinical practice.
Quiroga, B., Galan, I., Garcia de Vinuesa, S., Goicoechea, M., Verdalles, U., Luno, J.
Nephrol Dial Transplant. 2015 Mar 9. pii: gfv059. [Epub ahead of print]
MedicalResearch.com Interview with: Dr. Borja Quiroga MD Ph.D. (2015). Interarm Blood Pressure Variability Linked To Greater Cardiovascular Risk in CKD