title: Increased protein intake is associated with uncontrolled blood pressure by 24-hour ambulatory blood pressure monitoring in patients with type 2 diabetes.
abstract: OBJECTIVE
  To analyze possible associations of dietary components, especially protein intake, with blood pressure (BP) during ambulatory BP monitoring (ABPM) in patients with type 2 diabetes.
  
  
  METHODS
  In this cross-sectional study, BP of outpatients with type 2 diabetes was evaluated by 24-hour ABPM (Spacelabs 90207) and usual diet by 3-day weighed diet records. Patients were divided into 2 groups according to their daytime ABPM: uncontrolled BP (systolic BP ≥ 135 mmHg or diastolic BP ≥ 85 mmHg) and controlled BP (systolic BP < 135 mmHg and diastolic BP < 85 mmHg). Logistic regression models unadjusted and adjusted for possible confounders (covariates) were used to analyze the association of protein and uncontrolled BP.
  
  
  RESULTS
  A total of 121 patients with type 2 diabetes aged 62.3 years, 54.5% of whom were women, were studied. The uncontrolled BP group had higher glycated hemoglobin (HbA1C) values (8.4 ± 2.0 vs 7.6 ± 1.3%; p = 0.04) and consumed more protein (20.0 ± 3.8 vs 18.2 ± 3.6% of energy; p = 0.01) and meat, (2.6 [1.45, 2.95] vs 2.0 [1.49, 2.90] g/kg weight; p = 0.04) than the controlled BP group. In a multivariate analysis, protein intake (% of energy) increased the chance for uncontrolled BP (odds ratio [OR] = 1.16; 95% confidence interval [CI], 1.02, 1.30; p = 0.02), adjusted for body mass index (BMI), HbA1C, low-density lipoprotein (LDL) cholesterol, number of antihypertensive medications, and ethnicity. Meat consumption higher than 3.08 g/kg weight/day more than doubled the chance for uncontrolled BP (OR = 2.53; 95% CI, 1.01, 7.60; p = 0.03).
  
  
  CONCLUSIONS
  High protein intake and meat consumption were associated with high daytime ABPM values in patients with type 2 diabetes. Reducing meat intake might represent an additional dietary intervention in hypertensive patients with type 2 diabetes.
authors.affiliation: a Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , BRAZIL.
authors.forename: Carolina B
authors.initials: CB
authors.lastname: Mattos
authors.forename: Luciana V
authors.initials: LV
authors.lastname: Viana
authors.forename: Tatiana P
authors.initials: TP
authors.lastname: Paula
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Sarmento
authors.forename: Jussara C
authors.initials: JC
authors.lastname: Almeida
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Gross
authors.forename: Mirela J
authors.initials: MJ
authors.lastname: Azevedo
mesh_terms: D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000209:etiology; D004044:Dietary Proteins / Q000009:adverse effects*; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008460:Meat; D008875:Middle Aged
chemical_list: D004044:Dietary Proteins; D006442:Glycated Hemoglobin