RT Journal Article
SR Electronic
T1 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
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 1908
OP 1912
DO 10.2337/dc12-2087
VO 36
IS 7
A1 Okada, Hiroshi
A1 Fukui, Michiaki
A1 Tanaka, Muhei
A1 Matsumoto, Shinobu
A1 Mineoka, Yusuke
A1 Nakanishi, Naoko
A1 Asano, Mai
A1 Yamazaki, Masahiro
A1 Hasegawa, Goji
A1 Nakamura, Naoto
YR 2013
UL http://care.diabetesjournals.org/content/36/7/1908.abstract
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.