Nocturnal hypertension: will control of nighttime blood pressure prevent progression of diabetic renal disease?
Patients with type 1 and 2 diabetes and nephropathy frequently have a blunted fall in nighttime arterial blood pressure. This abnormality is already seen in subjects with type 1 diabetes who are in the microalbuminuric phase of the disease, and we have also shown that an increase in nighttime systolic blood pressure precedes the development of microalbuminuria. These studies suggest that nocturnal hypertension may be an important early predictor of diabetic nephropathy. Various drugs have different effects on nocturnal blood pressure, and chronotherapy may be key in determining clinical outcomes. There is a compelling need for studies showing that treating nocturnal hypertension in diabetes can prevent renal disease progression.
Moorthi
K M
KM
Division of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, 320 East Superior, Searle 10-475, Chicago, IL 60611, USA.
Hogan
Donn
D
Lurbe
Empar
E
Redon
Josep
J
Batlle
Daniel
D
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination; D016022:Case-Control Studies; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D007677:Kidney Function Tests; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index
D000959:Antihypertensive Agents