title: Isolated home hypertension in the morning is associated with target organ damage in patients with type 2 diabetes.
abstract: To investigate the relationship between the blood pressure control level and cardiovascular risk in type 2 diabetic patients, we evaluated home blood pressure, office blood pressure, biochemical data, and carotid echographic and echocardiographic findings in 148 patients with type 2 diabetes. According to the criteria for hypertension in the guidelines of the Japanese Society of Hypertension, we classified patients into a normotensive group with home systolic blood pressure in the morning (morning HSBP)<135 mmHg and office systolic blood pressure (OSBP)<140 mmHg, an office hypertension group with a morning HSBP<135 mmHg and OSBP>or=140 mmHg, an isolated home hypertension in the morning group with morning HSBP>or=135 mmHg and OSBP<140 mmHg, and a sustained hypertension group with morning HSBP>or=135 mmHg and OSBP>or=140 mmHg. In the isolated home hypertension in the morning group, the fasting insulin level, urinary albumin excretion, maximum carotid artery intima-media complex thickness, and left ventricular posterior wall thickness were significantly higher and the coefficient of variation for RR intervals was significantly lower than in the normotensive group. These results suggest that isolated home hypertension in the morning is a risk factor for target organ damage in type 2 diabetic patients.
authors.affiliation: Division of Internal Medicine, the Harima Hospital of the Ishikawajima Harima Heavy Industries Health Insurance Society, Hyogo, Japan. kzhkskgc@apple.kci.ne.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Horimatsu
authors.forename: Minoru
authors.initials: M
authors.lastname: Kishi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ohnishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Koike
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Maeda
mesh_terms: D000368:Aged; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000209:etiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D012648:Self Care