Systolic blood pressure relates to the rate of progression of albuminuria in NIDDM.
We prospectively followed a cohort of 278 non-insulin-dependent (NIDDM) patients for a 6-year period, intending to estimate the rate of increase of albuminuria and to identify clinical variables that influence this increase. At baseline, normo-albuminuria (N) was seen in 74%, microalbuminuria (M) in 19% and 7% presented with proteinuria (P). A total of 80 patients died; they were older (p < 0.001) and had higher albumin excretion both at baseline and as an average during follow-up (p < 0.01). At baseline, patients with proteinuria had higher blood pressures (systolic and diastolic), whereas there was no difference between patients with normo-and microalbuminuria. Glycaemic control was increasingly poor throughout the three groups. At follow-up, an average relative rate of increase of albuminuria (slope) of 17% per year was seen both for patients with complete 6 years, follow-up (n - 135) and patients with at least 4 years follow-up (n = 178). Slope correlated significantly with systolic blood pressure (r = 0.26 and 0.29) in both groups, diastolic blood pressure only in the 4-year group (r = 0.22) and average albuminuria in both (r = 0.31 and 0.24). By multiple regression analyses systolic blood pressure and average albuminuria remained with significant influence on slope. Progression was defined as an increase in the category (e.g. normo- to microalbuminuria) as well as an increase of more than 20% in albumin excretion, and was seen in 46 patients with at least 4 years' follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
Schmitz
A
A
Medical Department M, Diabetes and Endocrinology, Aarhus Kommunehospital, Denmark.
Vaeth
M
M
Mogensen
C E
CE
D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000419:Albuminuria; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000503:physiopathology; D003971:Diastole; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria; D013599:Systole; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin