P222 PREDICTOR FACTORS OF UNCONTROLLED MASKED HYPERTENSION IN PATIENTS WITH HYPERTENSION WITH CHRONIC KIDNEY DISEASE

Background and Objective: Masked uncontrolled hypertension (MUCH) is commonly observed in patients with hypertension who are normotensive in the clinic. MUCH is associated with increased risk for target- organ damage and adverse cardiovascular and renal outcomes in high-risk patients, such as those with chronic kidney disease (CKD). The objective of this study was to evaluate predictors of MUCH in patients with hypertension and CKD. Methods: This was cross-sectional study that performed 24-hour ambulatory blood pressure (BP) monitoring (ABPM) in 220 patients with hypertension and CKD (glomerular filtration rate <60 mL/min/1.73 m2) and controlled BP in the office (<140/90 mmHg). We categorized participants into two groups: 1) controlled BP group (24-hour ABPM <130/80 mmHg), and 2) MUCH group (24-hour ABPM ≥130/80 mmHg). Epidemiological, clinical, anthropometric variables and laboratory data were collected and compared between the two groups. We used logistic-regression models to identify the predictors of MUCH. Results: Approximately half of patients (n=109, 49.6%) had MUCH. Higher office BP values were observed in patients classified as controlled BP, both systolic (127 vs 125 mmHg, p=0.06) and diastolic BP (75 vs 72 mmHg, p=0.01). When analyzing anthropometric variables, a higher body mass index (BMI) was noted in the controlled BP group (26 vs 28 kg/m2, p<0.01). Regarding laboratory data, higher levels of urine albumin-creatinine ratio (uACR) were observed in the MUCH group (275 vs 69 mg/g, p<0.01). In a logistic regression model, were significant: diastolic BP in the office between 75 and 89 mmHg (OR: 1.93, 95%CI 1.03-3.64; p=0.04), BMI <25Kg/m2 (OR: 2.21, 95%CI 1.08-4.52; p=0.03) and uACR greater than 300 mg/g (OR: 3.26, 95%CI 1, 71-6.19; p<0.01). Conclusion: In patients with CKD and BP controlled at the office, diastolic BP in the office between 75 and 89 mmHg, BMI <25 kg/m2 and uACR >300 mg/g were predictive factors for MUCH.