Prognostic importance of home blood pressure measurement in patients with diabetic nephropathy

被引:2
作者
Nishimura M. [1 ]
Kato M. [2 ]
Shimada F. [3 ]
Kato Y. [4 ]
Todo R. [5 ]
Ando Y. [6 ]
Hida K. [7 ]
Iseda I. [7 ]
Tone A. [7 ]
Nagase N. [8 ]
Yoshizumi H. [9 ]
Higashi K. [10 ]
Hoshiyama Y. [11 ]
机构
[1] Department of Internal Medicine, National Hospital Organization Chiba-East National Hospital, Chiba, Chiba 260-8712, 673 Nitonachou, Chuou-ku
[2] Hokkaido Medical Center, Sapporo, Hokkaido 063-0005, 5-7-1-1 Yamanote, Nishi-ku
[3] Chiba Medical Center, Chiba, Chiba 260-8606, 4-1-2 Tsubakimori, Chuou-ku
[4] Nagoya Medical Center, Nagoya, Aichi 460-0001, 4-1-1 Sannomaru, Naka-ku
[5] Osaka National Hospital, Osaka, Osaka 540-0006, 2-1-14 Hoenzaka, Chuo-ku
[6] Osaka Minami Medical Center, Kauchinagano, Osaka 586-8521
[7] Okayama Medical Center, Okayama, Okayama 701-1192, 1711-1 Tamasu, Kita-ku
[8] Higashi-Tokushima Hospital, Itano, Tokushima 779-0193, 1-1 Ootera Aza Oomukaikita, Itano Town
[9] Kyushu Medical Center, Fukuoka, Fukuoka 810-8563, 1-8-1 Jigyohama, Chuou-ku
[10] Kumamoto Medical Center, Kumamoto, Kumamoto 860-0008
[11] University of Human Arts and Sciences, Saitama, Saitama 339-8539, 1288 Magome, Iwatsuki-ku
关键词
Diabetic nephropathy; Home blood pressure; Hypertension; Type; 2; diabetes;
D O I
10.1007/s13340-011-0018-y
中图分类号
学科分类号
摘要
Aims: Controlling hypertension has been revealed to be as important as controlling hyperglycemia to prevent the progression of diabetic nephropathy. Home blood pressure (HBP) measurement is useful for the treatment of hypertension. This study aimed to determine whether HBP measurement is a stronger predictor of the progression of diabetic nephropathy than clinic blood pressure (CBP) measurement. Method: A multicenter follow-up study was performed at the Japan National Hospital Organization. A database of type 2 diabetic patients was constructed. In addition to CBP measurement patients, those using HBP were included in the database. Fifty-four patients with diabetic nephropathy were extracted from the database and analyzed. The rate of decline of the estimated glomerular filtration rate (eGFR) was calculated as the outcome. Correlations between the rate of eGFR decline and various clinical and laboratory parameters, including HBP and CBP measurement, were analyzed. Results: The white-coat effect and reverse white-coat effect were frequently observed. The rate of eGFR decline correlated significantly with home systolic blood pressure (HSBP) measurement, but not with clinic systolic blood pressure (CSBP) measurement. Stepwise multiple linear regression analysis was performed. The rate of eGFR decline was significantly explained by the morning HSBP reading. The rate of eGFR decline was also significantly explained by the average of the morning HSBP readings during the follow-up period, the eGFR and age at baseline in the model, which included CBP and HBP measurements during the follow-up period instead of those at baseline. Conclusion: Home blood pressure measurement is useful for predicting the prognosis of diabetic nephropathy. © 2011 The Japan Diabetes Society.
引用
收藏
页码:10 / 18
页数:8
相关论文
共 22 条
[1]  
Adler A.I., Stevens R.J., Manley S.E., Bilous R.W., Cull C.A., Holman R.R., Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64), Kidney Int, 63, pp. 225-232, (2003)
[2]  
Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes, 317, pp. 703-713, (1998)
[3]  
Standards of medical care in diabetes-2008. Diabetes Care, SUPPL. 1, pp. 12-54, (2008)
[4]  
Ogihara T., Kikuchi K., Matsuoka H., Fujita T., Et al., The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009), Hypertens Res, 32, pp. 3-107, (2009)
[5]  
Hovind P., Rossing P., Tarnow L., Smidt U.M., Parving H.H., Remission and regression in the nephropathy of type 1 diabetes when blood pressure is controlled aggressively, Kidney Int, 60, pp. 277-283, (2001)
[6]  
Rossing K., Christensen P.K., Hovind P., Parving H.H., Remission of nephrotic-range albuminuria reduces risk of end-stage renal disease and improves survival in type 2 diabetic patients, Diabetologia., 48, pp. 2241-2247, (2005)
[7]  
Perkins B.A., Ficociello L.H., Silva K.H., Finkelstein D.M., Warram J.H., Krolewski A.S., Regression of microalbuminuria in type 1 diabetes, N Engl J Med, 348, pp. 2285-2293, (2003)
[8]  
Araki S., Haneda M., Sugimoto T., Isono M., Isshiki K., Et al., Factors associated with frequent remission of microalbuminuria in patients with type 2 diabetes, Diabetes., 54, pp. 2983-2987, (2005)
[9]  
Gaede P., Vedel P., Larsen N., Jensen G.V., Parving H.H., Pedersen O., Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes, N Engl J Med, 348, pp. 383-393, (2003)
[10]  
Cappuccio F.P., Kerry S.M., Forbes L., Donald A., Blood pressure control by home monitoring: meta-analysis of randomised trials, BMJ., 329, (2004)