Blood pressure may be one of the most important modifiable risk factors for cardiovascular
disease in patients with end-stage-renal-disease undergoing maintenance hemodialysis.
Although a systolic blood pressure <140 mmHg treatment target has been recommended, there
remains uncertainty on which blood pressure should be targeted, more specifically that
measured in the dialysis unit or at home. Observational studies have reported a paradoxical
U-shaped associated with dialysis unit (pre-dialysis) systolic blood pressure and
cardiovascular events and death (where blood pressure below 140 mmHg is actually linked with
poor outcomes). Conversely, the same studies have reported a linear association between
higher home systolic blood pressure and worse clinical outcomes, where blood pressure below
140 mmHg is associated with better outcomes. This pilot clinical trial aims to address this
important question.