Impact of Isolated High Home Systolic Blood Pressure and Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus: A 5-Year Prospective Cohort Study.

Nobuko Kitagawa,Michiaki Fukui,Naoko Nakanishi,Masahide Hamaguchi,Noriyuki Kitagawa,Isao Yokota,Emi Ushigome,Masahiro Yamazaki,Hidetaka Ushigome,Mai Asano

doi:10.3390/jcm10091929

Abstract

Background: A previous 2-year cohort study has shown that isolated high home systolic blood pressure (IH-HSBP) may increase the risk of diabetic nephropathy, using normal HBP as a reference. However, this association has not been previously assessed in the medium to long term. Methods: This prospective 5-year cohort study of 424 patients, with normal or mildly increased albuminuria, investigated the effect of IH-HSBP on the risk of diabetic nephropathy in patients with type 2 diabetes mellitus. Diabetic nephropathy was defined as an advancement from normal or mildly increased albuminuira to moderate or severely increased albuminuria. Results: Among 424 patients, 75 developed diabetic nephropathy during the study period. The adjusted odds ratio for developing diabetic nephropathy given IH-HSBP was 2.39 (95% confidence interval, 1.15–4.96, p = 0.02). The odds ratio for developing nephropathy in patients with IH-HSBP younger than 65 years was higher than that in patients with IH-HSBP older than 65 years. Conclusion: IH-HSBP was associated with an increased risk of diabetic nephropathy among type 2 diabetes mellitus patients with normal or mildly increased albuminuria in the medium to long term. The results support and strengthen previous reports. These findings suggest that IH-HSBP might be a useful marker in disease prognostication.

Highlights

Home blood pressure (HBP) control is paramount to diabetic nephropathy prevention [1]
Our group has previously shown that isolated high home systolic blood pressure (IH-HSBP) might be a useful marker in the prognostication of diabetic nephropathy, based on data from a 2-year cohort study [8]
We performed a follow-up study with patients diagnosed with type 2 diabetes mellitus (DM), aiming to provide a valid assessment of the impact of Isolated systolic hypertension (ISH) on the risk of diabetic nephropathy in this patient group over the medium to long term

Summary

Introduction

Home blood pressure (HBP) control is paramount to diabetic nephropathy prevention [1]. The follow-up period in that study was relatively short, likely limiting its statistical power To address this limitation, we performed a follow-up study with patients diagnosed with type 2 diabetes mellitus (DM), aiming to provide a valid assessment of the impact of ISH on the risk of diabetic nephropathy in this patient group over the medium to long term. A previous 2-year cohort study has shown that isolated high home systolic blood pressure (IH-HSBP) may increase the risk of diabetic nephropathy, using normal HBP as a reference. This association has not been previously assessed in the medium to long term

Methods

Results

Conclusion