title: Optimal home SBP targets for preventing the progression of diabetic nephropathy in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Home blood pressure control can reduce the risk of increased urinary albumin excretion in patients with diabetes mellitus. However, the optimal home blood pressure targets to prevent the onset or progression of diabetic nephropathy are not well defined.
  
  
  METHODS
  We performed a retrospective cohort study of 851 patients with type 2 diabetes mellitus. Logistic regression models were used to evaluate the correlations of home SBP levels with progression of diabetic nephropathy.
  
  
  RESULTS
  During the follow-up of 2 years, 86 patients had progression of diabetic nephropathy. Adjusted odds ratios (95% confidence interval) for progression of diabetic nephropathy in patients with morning SBP of 120-129  mmHg [2.725 (1.074-6.917), P = 0.035], 130-139  mmHg [3.703 (1.519-9.031), P = 0.004] and in those with morning SBP equal or more than 140  mmHg [2.994 (1.182-7.581), P = 0.021] were significantly higher than that in those with morning SBP less than 120  mmHg in multiple logistic analyses.
  
  
  CONCLUSIONS
  The preferable morning SBP targets might be less than 120  mmHg for preventing the onset or progression of diabetic nephropathy in patients with type 2 diabetes mellitus.
authors.affiliation: aDepartment of Endocrinology and Metabolism, Kyoto Prefectural University, of Medicine, Graduate School of Medical Science bDepartment of Endocrinology and Metabolism, Kyoto First Red Cross Hospital cDepartment of Endocrinology and Metabolism, Kyoto Second Red Cross Hospital, Kyoto dDepartment of Endocrinology and Metabolism, Osaka General Hospital of West Japan Railway Company, Osaka eDepartment of Cardiology, Nishijin Hospital, Kyoto, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ushigome
authors.forename: Masahide
authors.initials: M
authors.lastname: Hamaguchi
authors.forename: Shinobu
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Chikako
authors.initials: C
authors.lastname: Oyabu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Omoto
authors.forename: Toru
authors.initials: T
authors.lastname: Tanaka
authors.forename: Wataru
authors.initials: W
authors.lastname: Fukuda
authors.forename: Goji
authors.initials: G
authors.lastname: Hasegawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Mogami
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ohnishi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Sei
authors.initials: S
authors.lastname: Tsunoda
authors.forename: Yohei
authors.initials: Y
authors.lastname: Oda
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology* / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies