Morning pulse pressure is associated more strongly with elevated albuminuria than systolic blood pressure in patients with type 2 diabetes mellitus: Post hoc analysis of a cross-sectional multicenter study

被引:8
|
作者
Ushigome, Emi [1 ]
Fukui, Michiaki [1 ]
Hamaguchi, Masahide [2 ]
Matsumoto, Shinobu [1 ]
Mineoka, Yusuke [1 ]
Nakanishi, Naoko [1 ]
Senmaru, Takafumi [1 ]
Yamazaki, Masahiro [1 ]
Hasegawa, Goji [1 ]
Nakamura, Naoto [1 ]
机构
[1] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Endocrinol & Metab, Kamigyo Ku, Kyoto 6028566, Japan
[2] Osaka Univ, Immunol Frontier Res Ctr, Suita, Osaka 5650871, Japan
关键词
Diabetic nephropathy; Home blood pressure monitoring; Arteriosclerosis; CORONARY-HEART-DISEASE; CARDIOVASCULAR MORTALITY; ENDOTHELIAL DYSFUNCTION; RISK; HYPERTENSION; MICROALBUMINURIA; ATHEROSCLEROSIS; NEPHROPATHY; SOCIETY; OFFICE;
D O I
10.1016/j.diabres.2013.07.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: Recently, focus has been directed toward pulse pressure as a potentially independent risk factor for micro- and macrovascular disease. This study was designed to examine the relationship between pulse pressure taken at home and elevated albuminuria in patients with type 2 diabetes. Methods: This study is a post hoc analysis of a cross-sectional multicenter study. Home blood pressure measurements were performed for 14 consecutive days in 858 patients with type 2 diabetes. We investigated the relationship between systolic blood pressure or pulse pressure in the morning or in the evening and urinary albumin excretion using univariate and multivariate analyses. Furthermore, we measured area under the receiver-operating characteristic curve (AUC) to compare the ability to identify elevated albuminuria, defined as urinary albumin excretion equal to or more than 30 mg/g creatinine, of systolic blood pressure or pulse pressure. Results: Morning systolic blood pressure (beta = 0.339, P < 0.001) and morning pulse pressure (beta = 0.378, P < 0.001) were significantly associated with logarithm of urinary albumin excretion independent of other potential co-factors. AUC for elevated albuminuria in morning systolic blood pressure and morning pulse pressure were 0.668 (0.632-0.705; P < 0.001) and 0.694 (0.659-0.730; P < 0.001), respectively. AUC of morning pulse pressure was significantly greater than that of morning systolic blood pressure (P = 0.040). Conclusions: Our findings implicate that morning pulse pressure is associated with elevated albuminuria in patients with type 2 diabetes, which suggests that lowering morning pulse pressure could prevent the development and progression of diabetic nephropathy. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:270 / 277
页数:8
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