title: Uncontrolled home blood pressure in the morning is associated with nephropathy in Japanese type 2 diabetes.
abstract: The purposes of this study were to investigate the state of blood pressure control level and to investigate the relationship between blood pressure control level and nephropathy in Japanese type 2 diabetes. We measured clinic and home blood pressure in 923 type 2 diabetic patients. According to the criteria for hypertension in the Japanese Society of Hypertension Guidelines 2009, patients were classified into four groups by clinic systolic blood pressure (130 mmHg) and morning systolic blood pressure (125 mmHg), as follows: controlled hypertension (CH), white-coat hypertension (WCH), masked hypertension (MH), and sustained hypertension (SH). Of all patients, 13.9, 12.6, 13.3, and 60.2% were identified as having CH, WCH, MH, and SH, respectively. The average number of drugs prescribed was 1.8. We assessed the association between blood pressure control level and nephropathy in diabetic patients. The degree of urinary albumin excretion and the prevalence of nephropathy in diabetic patients were higher in MH and SH groups than those in the CH group. The majority of patients had poor blood pressure control, regardless of ongoing conventional antihypertensive therapy, and diabetic patients with MH and SH were associated with nephropathy. It is suggested that more aggressive antihypertensive treatment is recommended to prevent nephropathy in diabetic patients.
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ushigome
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
authors.forename: Kazumi
authors.initials: K
authors.lastname: Sakabe
authors.forename: Muhei
authors.initials: M
authors.lastname: Tanaka
authors.forename: Shinobu
authors.initials: S
authors.lastname: Inada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Omoto
authors.forename: Toru
authors.initials: T
authors.lastname: Tanaka
authors.forename: Wataru
authors.initials: W
authors.lastname: Fukuda
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Atsuta
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ohnishi
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Mogami
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Yohei
authors.initials: Y
authors.lastname: Oda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Goji
authors.initials: G
authors.lastname: Hasegawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination; D016009:Chi-Square Distribution; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D059466:White Coat Hypertension / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents