PT  - JOURNAL ARTICLE
AU  - Okada, Hiroshi
AU  - Fukui, Michiaki
AU  - Tanaka, Muhei
AU  - Matsumoto, Shinobu
AU  - Mineoka, Yusuke
AU  - Nakanishi, Naoko
AU  - Asano, Mai
AU  - Yamazaki, Masahiro
AU  - Hasegawa, Goji
AU  - Nakamura, Naoto
TI  - Visit-to-Visit Blood Pressure Variability Is a Novel Risk Factor for the Development and Progression of Diabetic Nephropathy in Patients With Type 2 Diabetes
AID  - 10.2337/dc12-2087
DP  - 2013 Jul 01
TA  - Diabetes Care
PG  - 1908--1912
VI  - 36
IP  - 7
4099  - http://care.diabetesjournals.org/content/36/7/1908.short
4100  - http://care.diabetesjournals.org/content/36/7/1908.full
SO  - Diabetes Care2013 Jul 01; 36
AB  - OBJECTIVE Recent study has suggested that not only the presence of hypertension but also the variability in systolic blood pressure (SBP) are risk factors for vascular disease and organ damage. The aim of this study was to investigate the relationship between visit-to-visit variability in SBP and change in urinary albumin excretion (UAE) or development of albuminuria in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS We measured SBP in 354 consecutive patients at every visit during 1 year and calculated the coefficient of variation (CV) of SBP. We performed a follow-up study to assess change in UAE or development of albuminuria, the mean interval of which was 3.76 ± 0.71 years. Then, we evaluated relationships of variability of SBP to diabetic nephropathy using multiple regression analysis and multiple Cox regression model.RESULTS Multiple regression analysis demonstrated that CV of SBP was independently associated with change in UAE (β = 0.1758; P = 0.0108). Adjusted Cox regression analyses demonstrated that CV of SBP was associated with an increased hazard of development of albuminuria; hazard ratio was 1.143 (95% CI 1.008–1.302).CONCLUSIONS Visit-to-visit variability in SBP could be a novel risk factor for the development and progression of diabetic nephropathy in patients with type 2 diabetes.