title: Association of high pulse pressure with proteinuria in subjects with diabetes, prediabetes, or normal glucose tolerance in a large Japanese general population sample.
abstract: OBJECTIVE
  To examine whether there is a difference in the association between high pulse pressure and proteinuria, independent of other blood pressure (BP) indices, such as systolic or diastolic BP, among subjects with diabetes, prediabetes, or normal glucose tolerance.
  
  
  METHODS
  Using a nationwide health checkup database of 228,778 Japanese aged ≥ 20 years (mean 63.2 years; 39.3% men; none had pre-existing cardiovascular disease), we examined the association between high pulse pressure, defined as the highest quintile of pulse pressure (≥ 63 mmHg, n = 40,511), and proteinuria (≥ 1+ on dipstick, n = 12,090) separately in subjects with diabetes (n = 27,913), prediabetes (n = 100,214), and normal glucose tolerance (n = 100,651).
  
  
  RESULTS
  The prevalence of proteinuria was different among subjects with diabetes, prediabetes, and normal glucose tolerance (11.3 vs. 5.0 vs. 3.9%, respectively; P < 0.001). In subjects with diabetes, but not those with prediabetes or normal glucose tolerance, high pulse pressure was associated with proteinuria independently of significant covariates, including systolic BP (odds ratio 1.15 [95% CI 1.04-1.28]) or diastolic or mean BP (all P < 0.01). In patients with diabetes, a +1 SD increase of pulse pressure (+13 mmHg) was associated with proteinuria, even after adjustment for systolic BP (1.07 [1.00-1.13]) or diastolic or mean BP (all P < 0.05).
  
  
  CONCLUSIONS
  Among the Japanese general population, there was a significant difference in the association between high pulse pressure and proteinuria among subjects with diabetes, prediabetes, and normal glucose tolerance. Only in diabetes was high pulse pressure associated with proteinuria independent of systolic, diastolic, or mean BP levels.
authors.affiliation: Divisions of Community and Family Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Konta
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Moriyama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshida
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Issei
authors.initials: I
authors.lastname: Kurahashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001786:Blood Glucose; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014655:Vascular Resistance
chemical_list: D001786:Blood Glucose