title: A New Proposal for the Target Value for Home BP in Type 2 Diabetes Patients: The J-HOP Study.
abstract: OBJECTIVE
  The target levels of home-monitored blood pressure (BP) in patients with type 2 diabetes mellitus (T2DM) have not yet been established. We sought to examine the appropriate target home BP level in T2DM.
  
  
  METHODS
  This is a subanalysis of the Japan Morning Surge-Home Blood Pressure (J-HOP) study. We enrolled 4,310 patients who had at least 1 cardiovascular risk factor, and clinic and home BP monitoring was performed. The urinary albumin-to-creatinine ratio (UACR) was measured as a marker of microvascular disease. Quadratic equations of the relationship between clinic/home systolic BP (SBP) and log-transformed UACR were used to determine the home BP value. Home BP levels corresponding to clinic SBP/diastolic BP (DBP) level using the UACR values were calculated separately by the presence/absence of diabetes.
  
  
  RESULTS
  The mean age of the patients was 64.9±10.9 years; 47.0% were males. Of the 4,310 subjects enrolled, 1,057 (24.5%) had T2DM (the DM group) and 3,253 (75.5%) did not (non-DM group). The home BP levels equivalent to clinic BP 140/90 mm Hg were 135/84 and 135/83 mm Hg in the DM and non-DM groups, respectively. The home SBP levels equivalent to clinic SBP 130/80 mm Hg were 122/79 mm Hg in the non-DM group and 129/78 mm Hg in the DM group.
  
  
  CONCLUSIONS
  Regardless of diabetic status, the home BP level that corresponds to the clinic SBP 140/90 mm Hg was 135/85 mm Hg. In patients with T2DM, the home SBP level equivalent to clinic SBP 130/80 mm Hg was 129/78 mm Hg with regard to the extent of microvascular disease.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan; ke112@jichi.ac.jp.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Eguchi
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan;
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan;
authors.forename: Takahiro
authors.initials: T
authors.lastname: Komori
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Nagasaka
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan;
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000652:urine; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000503:physiopathology* / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged
chemical_list: D003404:Creatinine
keywords: blood pressure; home BP; hypertension; type 2 diabetes; urinary microalbumin