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High pulse pressure associated with greater death risk in dialysis patients

DURHAM, N.C. -- A Duke University Medical Center study of dialysis patients indicates that a new way of looking at traditional blood pressure numbers may be important in determining which patients are at highest risk of dying.

Almost 20 percent of dialysis patients die each year, usually from heart disease. By better understanding pulse pressure, doctors may be able to identify high-risk patients and take steps to keep those patients alive. The study is featured in the March 27, 2002 issue of the Journal of the American Medical Association.

The study looked at pulse pressure, which is the difference between blood pressure's two key numbers: systolic blood pressure (top number) and diastolic blood pressure (bottom number). For example, a blood pressure 120/80 has a pulse pressure of 40. Pulse pressure has previously been shown to be a powerful predictors of heart attacks, heart failure and death in patients who are not on dialysis.

The Duke University researchers examined pulse pressure in dialysis patients because this population shows an unusual relationship between traditional blood pressure measurements and death.

"In the general population, people who have higher blood pressure have a greater risk of dying," said Dr. Preston Klassen, lead author of the study and nephrologist at Duke University Medical Center. "In dialysis patients, that relationship at first glance appears to be reversed. Dialysis patients with higher blood pressures seem to live longer than dialysis patients with lower blood pressures. We decided to examine pulse pressures in dialysis patients to see what the relationship was between pulse pressure and death."

The Duke researchers examined existing data from more than 37,000 patients undergoing hemodialysis across the United States. They analyzed patients' pulse pressures and then correlated that information with which patients died during the course of one year. The analysis showed that dialysis patients, like pat
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Contact: Amy Austell
amy.austell@duke.edu
919-684-4148
Duke University Medical Center
26-Mar-2002


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