Pulse pressure and albuminuria in type 2 diabetes

Introduction: The influence of elevated pulse pressure and blood pressure on albuminuria in type 2 diabetes was examined. Method: 166 patients with type 2 diabetes and related complications (100 women, 66 men, all with a mean age of 66, mean diabetes duration of 8.75 years, mean BMI of 30.52 +/- 5.47 kg/m(2), and mean WHR of 0.92 +/- 0.09) were recruited from a single medical practice. A subsequent continuous blood pressure monitoring for at least 22 hours was performed on each patient, as well as a 24-hour urine sample. Results: Elevations in age, pulse pressure, systolic blood pressure (RRsys), HbA(1c),, values, as well as fasting and postprandial glucose all had a significant influence on microalbuminuria (p < 0.05). The presence of microalbuminuria was always accompanied by a significantly high pulse pressure: 58.27 +/- 11.7 mmHg (vs. 53.24 +/- 9.39 mmHg). Macroalbuminuria was frequently found in patients with a pulse pressure of over 70 +/- 10.3mmHg. The non-dipping phenomenon occurred in 71 % of the cases. Furthermore, the presence of albuminuria and high pulse pressure correlated with the presence of cardiovascular complications, Summary: High pulse pressure, with or without elevated RRsys, was found to be an independent risk factor for the presence of microalbuminuria. The continuous 24hour blood pressure monitoring is a crucial method for diagnosis and therapy control in type 2 diabetes.