title: Visit-to-visit blood pressure variability is a novel risk factor for the development and progression of diabetic nephropathy in patients with type 2 diabetes.
abstract: OBJECTIVE
  Recent study has suggested that not only the presence of hypertension but also the variability in systolic blood pressure (SBP) are risk factors for vascular disease and organ damage. The aim of this study was to investigate the relationship between visit-to-visit variability in SBP and change in urinary albumin excretion (UAE) or development of albuminuria in patients with type 2 diabetes.
  
  
  METHODS
  We measured SBP in 354 consecutive patients at every visit during 1 year and calculated the coefficient of variation (CV) of SBP. We performed a follow-up study to assess change in UAE or development of albuminuria, the mean interval of which was 3.76 ± 0.71 years. Then, we evaluated relationships of variability of SBP to diabetic nephropathy using multiple regression analysis and multiple Cox regression model.
  
  
  RESULTS
  Multiple regression analysis demonstrated that CV of SBP was independently associated with change in UAE (β = 0.1758; P = 0.0108). Adjusted Cox regression analyses demonstrated that CV of SBP was associated with an increased hazard of development of albuminuria; hazard ratio was 1.143 (95% CI 1.008-1.302).
  
  
  CONCLUSIONS
  Visit-to-visit variability in SBP could be a novel risk factor for the development and progression of diabetic nephropathy in patients with type 2 diabetes.
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors: Hiroshi
authors: H
authors: Okada
authors: Michiaki
authors: M
authors: Fukui
authors: Muhei
authors: M
authors: Tanaka
authors: Shinobu
authors: S
authors: Matsumoto
authors: Yusuke
authors: Y
authors: Mineoka
authors: Naoko
authors: N
authors: Nakanishi
authors: Mai
authors: M
authors: Asano
authors: Masahiro
authors: M
authors: Yamazaki
authors: Goji
authors: G
authors: Hasegawa
authors: Naoto
authors: N
authors: Nakamura
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin