Impact of masked hypertension on diabetic nephropathy in patients with type II diabetes: a KAMOGAWA-HBP study

Q1 Medicine

Journal of The American Society of Hypertension Pub Date : 2018-05-01 DOI:10.1016/j.jash.2018.02.005

Emi Ushigome MD, PhD , Chikako Oyabu MD , Toru Tanaka MD, PhD , Goji Hasegawa MD, PhD , Masayoshi Ohnishi MD, PhD , Sei Tsunoda MD, PhD , Hidetaka Ushigome MD, PhD , Isao Yokota MPH, PhD , Naoto Nakamura MD, PhD , Yohei Oda MD, PhD , Mai Asano MD, PhD , Muhei Tanaka MD, PhD , Masahiro Yamazaki MD, PhD , Michiaki Fukui MD, PhD

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引用次数: 11

Abstract

The prognostic significance of masked hypertension (MH) on the progression of diabetic nephropathy among patients with type II diabetes is not well documented. We examined the relationship between clinic systolic blood pressure (SBP) and morning home SBP measurements and progression to macroalbuminuria in patients with type II diabetes. We analyzed prospective cohort study data from 712 patients with type II diabetes. We classified the patients into the following four groups according to their clinic (130 mm Hg) and home (125 mm Hg) SBP measurements: controlled blood pressure group, white-coat hypertension group, MH group, and sustained hypertension (SH) group. The patients were instructed to perform triplicate morning and evening blood pressure measurements for 14 consecutive days. During the 2-year follow-up period, 23 patients progressed to macroalbuminuria. The unadjusted odds ratio (95% confidence interval) for progression to macroalbuminuria among the patients with MH was significantly higher than that among the patients with controlled blood pressure (8.89 [1.06–74.88]). No significant relationship was observed between white-coat hypertension or SH and progression to macroalbuminuria. In analyses adjusted for various potential confounders, the adjusted odds ratio for progression to macroalbuminuria in the MH group was more than 8-fold higher than that in the controlled blood pressure group. MH might be a predictor of progression to macroalbuminuria among patients with type II diabetes. This rate of progression is comparable with or greater than the results reported for patients with SH.

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隐瞒性高血压对II型糖尿病患者糖尿病肾病的影响:KAMOGAWA-HBP研究

隐匿性高血压(MH)对2型糖尿病患者糖尿病肾病进展的预后意义尚未得到很好的证实。我们研究了2型糖尿病患者临床收缩压(SBP)和早晨家庭收缩压测量与大蛋白尿进展之间的关系。我们分析了来自712例II型糖尿病患者的前瞻性队列研究数据。我们根据临床(130 mm Hg)和家庭(125 mm Hg)收缩压将患者分为控制血压组、白大褂高血压组、MH组和持续性高血压(SH)组。患者被指示连续14天进行三次早晚血压测量。在2年的随访期间，23例患者进展为巨量蛋白尿。MH患者进展为巨量蛋白尿的未调整优势比(95%可信区间)显著高于血压控制的患者(8.89[1.06-74.88])。没有观察到白大衣高血压或SH与进展为巨量白蛋白尿之间的显著关系。在对各种潜在混杂因素进行校正的分析中，MH组进展为巨量蛋白尿的校正优势比比控制血压组高出8倍以上。MH可能是2型糖尿病患者发展为大量蛋白尿的预测因子。这一进展率与报道的SH患者的结果相当或更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of The American Society of Hypertension PERIPHERAL VASCULAR DISEASE-

CiteScore

4.80

自引率

0.00%

发文量

审稿时长

6.6 weeks

期刊介绍： Cessation. The Journal of the American Society of Hypertension (JASH) publishes peer-reviewed articles on the topics of basic, applied and translational research on blood pressure, hypertension and related cardiovascular disorders and factors; as well as clinical research and clinical trials in hypertension. Original research studies, reviews, hypotheses, editorial commentary and special reports spanning the spectrum of human and experimental animal and tissue research will be considered. All research studies must have been conducted following animal welfare guidelines. Studies involving human subjects or tissues must have received approval of the appropriate institutional committee charged with oversight of human studies and informed consent must be obtained.