title: The effect of achieving a systolic blood pressure of 140 mmHg. A prospective study of ambulatory measurements in type 2 diabetic patients with nephropathy.
abstract: OBJECTIVE
  What is the prognostic significance of achieving a systolic blood pressure of <140 mmHg?
  
  
  METHODS
  Diabetic renal policlinic, university hospital of Lund, Sweden.
  
  
  METHODS
  118 type 2 diabetic patients with micro-macroalbuminuria were followed for four years (range 1-8 years). METHOD AND MAIN OUTCOME MEASURES: The prognostic significance of office, day- and nighttime measurements of blood pressure (BP) for development of cardiovascular complications was studied.
  
  
  RESULTS
  Forty-two percent (n=49) developed one or more of the following cardiovascular endpoints: 23% (n=27) death, 9% (n=10) stroke, 9% (n=11) myocardial infarction, 9% (n=11) heart failure, 31% (n=36) uremia and 17% (n=20) need for dialysis. Reaching the goal for day- and nighttime systolic BP (SBP) at baseline of <140 mmHg was associated with lower risk for developing uremia. Reaching the goal for nighttime SBP was associated with a decreased risk for developing myocardial infarction and need for dialysis treatment. None of these associations was found for office SBP. Patients not achieving the goal for nighttime systolic blood pressure of <140 mmHg had a 12.9 times higher risk of developing myocardial infarction and 3.9 times increased risk of uremia and 2.7 times increased risk for death than patients achieving the goal.
  
  
  CONCLUSIONS
  Nighttime blood pressure had better prognostic significance for developing cardiovascular and renal complications than office and daytime blood pressure.
authors: Department of Nephrology, Institution of Clinical Sciences, University Hospital of Lund, S-221 85 Lund, Sweden. ole.torffvit@med.lu.se
authors: Ole
authors: O
authors: Torffvit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000628:therapy; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D058246:Prehypertension / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012720:Severity of Illness Index; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D014511:Uremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
chemical_list: D000959:Antihypertensive Agents