Second measurement of morning systolic blood pressure is more closely associated with albuminuria.
OBJECTIVE
It is important to control blood pressure as well as to control blood glucose for the prevention of diabetic nephropathy. However, to our knowledge, there are no reports investigating which blood pressure, including morning, evening and clinic, is more closely associated with albuminuria and whether one measurement is sufficient or not in patients with Type 2 diabetes.


METHODS
We measured morning, evening and clinic blood pressure and compared the area under the curve (AUC) of blood pressure for urinary albumin excretion equal to or more than 30 mg/g creatinine using receiver-operating characteristic curve analyses and odds ratio for albuminuria defined as urinary albumin excretion equal to or more than 30 mg/g creatinine in 858 patients with Type 2 diabetes.


RESULTS
Odds ratio (95% confidence interval (CI)) of morning, evening and clinic systolic blood pressure for albuminuria was 1.034 (1.024 - 1.044), 1.033 (1.023 - 1.043) and 1.013 (1.055 - 1.021), respectively (p < 0.001 in all), and AUC of morning, evening and clinic systolic blood pressure was 0.644 (0.628 - 0.700) (p < 0.001 vs. clinic), 0.660 (0.623 - 0.696) (p < 0.001 vs. clinic) and 0.597 (0.559 - 0.636), respectively. AUC of the second morning systolic blood pressure was greater than the first (p = 0.033).


CONCLUSIONS
The second measurement of morning systolic blood pressure is more closely associated with albuminuria than the first measurement of the morning in addition to clinic systolic blood pressure.
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Kazumi
K
Sakabe
Michiaki
M
Fukui
Emi
E
Ushigome
Masahide
M
Hamaguchi
Toru
T
Tanaka
Haruhiko
H
Atsuta
Masayoshi
M
Ohnishi
Yohei
Y
Oda
Goji
G
Hasegawa
Naoto
N
Nakamura
D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000503:physiopathology*; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male