Authors: Lebel Marcel Kingma Iris Grose John H Langlois Serge
Publish Date: 1995/06/01
Volume: 8, Issue: 6, Pages: 545-551
Abstract
Marcel Lebel Iris Kingma John H Grose Serge Langlois Effect of recombinant human erythropoietin therapy on ambulatory blood pressure in normotensive and in untreated borderline hypertensive hemodialysis patients American Journal of Hypertension Volume 8 Issue 6 June 1995 Pages 545–551 https//doiorg/101016/089570619500035NThe effect of recombinant human erythropoietin rHuEPO on ambulatory blood pressure ABP was studied in 13 anemic hemodialysis patients Eight patients were normotensive and five patients had untreated borderline systolic hypertension Mean hemoglobin increased from 82 ± 3 g/L to 114 ± 3 g/L P 01 after 3 to 4 months of rHuEPO therapy 30 to 40 U/kg administered subcutaneously three times weekly Mean 24h systolic and diastolic ABP measurements were significantly increased by 16 ± 4 mm Hg and 10 ± 2 mm Hg respectively P 01 for both Blood pressure was increased in all but one patient In six patients the mean 24h systolic and diastolic ABP measurements were more than 160 mm Hg or 90 mm Hg at the end of the study The increase in ABP was slightly but not significantly greater during the waking period as compared with the sleeping period and the circadian blood pressure pattern was not modified by rHuEPO treatment The blood pressure load percentage of ABP readings exceeding 140/90 mm Hg during the waking period and 120/90 mm Hg during the sleeping period was significantly increased P 05 after rHuEPO therapy Nine of the 13 patients failed to show the expected reduction in blood pressure during the sleeping period and were defined as “nondippers” the others were defined as “dippers” During rHuEPO therapy the increase in ABP was similar in both dippers and nondippers This suggests that the nondipper condition is not a risk factor for the development of hypertension during rHuEPO therapy The increase in the 24h mean ABP was significantly greater in borderline systolic hypertensive patients than in normotensive patients 180 ± 25 mm Hg v 83 ± 30 mm Hg P 05 These results indicate that lowdose rHuEPO therapy administered subcutaneously may increase ABP in the normotensive patient but the effect on blood pressure could be expected to be much greater in the patient with preexisting borderline hypertension The increase in ABP in these 13 patients was comparable during both the waking and sleeping periods without any modification of the circadian blood pressure pattern
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