Prognostic importance of home blood pressure measurement in patients with diabetic nephropathy
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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.
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.
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.
Home blood pressure measurement is useful for predicting the prognosis of diabetic nephropathy.
- Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR, UKPDS Group. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003;63:225–32. CrossRef
- Idem. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. UKPDS 38. BMJ 1998;317:703–13.
- American Diabetes Association. Standards of medical care in diabetes-2008. Diabetes Care. 2008;Suppl 1:S12–54.
- 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. 2009;32:3–107.
- Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH. Remission and regression in the nephropathy of type 1 diabetes when blood pressure is controlled aggressively. Kidney Int. 2001;60:277–83. CrossRef
- Rossing K, Christensen PK, Hovind P, Parving HH. Remission of nephrotic-range albuminuria reduces risk of end-stage renal disease and improves survival in type 2 diabetic patients. Diabetologia. 2005;48:2241–7. CrossRef
- Perkins BA, Ficociello LH, Silva KH, Finkelstein DM, Warram JH, Krolewski AS. Regression of microalbuminuria in type 1 diabetes. N Engl J Med. 2003;348:2285–93. CrossRef
- 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. 2005;54:2983–7. CrossRef
- Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–93. CrossRef
- Cappuccio FP, Kerry SM, Forbes L, Donald A. Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ. 2004;329:145. CrossRef
- Ohkubo T, Imai Y, Tsuji I, Nagai K, Kato J, Kikuchi N, et al. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan. J Hypertens. 1998;16:971–5. CrossRef
- Bobrie G, Chatellier G, Genes N, Clerson P, Vaur L, Vaisse B, et al. Cardiovascular prognosis of “masked hypertension” detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004;291:1342–9. CrossRef
- Agarwal R, Andersen MJ. Prognostic importance of clinic and home blood pressure recordings in patients with chronic kidney disease. Kidney Int. 2006;69:406–11. CrossRef
- Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Tsukamoto Y, Ito S, Makino H, Hishida A, Matsuo S. Modification of the Modification of Diet in Renal Disease (MDRD) Study equation for Japan. Am J Kidney Dis. 2007;50:927–37. CrossRef
- Andersen MJ, Khawandi W, Agarwal R. Home blood pressure monitoring in CKD. Am J Kidney Dis. 2005;45:994–1001. CrossRef
- Bangash F, Agarwal R. Masked hypertension and white-coat hypertension in chronic kidney disease: a meta-analysis. Clin J Am Soc Nephrol. 2009;3:656–64. CrossRef
- Portaluppi F, Montanari L, Massari M, Di Chiara V, Capanna M. Loss of nocturnal decline of blood pressure in hypertension due to chronic renal failure. Am J Hypertens. 1991;4:20–6.
- Lantelme P, Milon H, Gharib C, Gayet C, Fortrat JO. White coat effect and reactivity to stress: cardiovascular and autonomic nervous system responses. Hypertension. 1998;31:1021–9.
- Brenner BM, Cooper ME, de Zeeuw D, RENAAL Study Investigators et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345:861–9. CrossRef
- Ruggenenti P, Gambara V, Perna A, Bertani T, Remuzzi G. The nephropathy of non-insulin-dependent diabetes: predictors of outcome relative to diverse patterns of renal injury. J Am Soc Nephrol. 1998;9:2336–43.
- Weiner DE, Tighiouart H, Levey AS, Elsayed E, Griffith JL, Salem DN, Sarnak MJ. Lowest systolic blood pressure is associated with stroke in stages 3 to 4 chronic kidney disease. J Am Soc Nephrol. 2007;18:960–6. CrossRef
- Minutolo R, Gabbai FB, Borrelli S, Scigliano R, Trucillo P, et al. Changing the timing of antihypertensive therapy to reduce nocturnal blood pressure in CKD: an 8-week uncontrolled trial. Am J Kidney Dis. 2007;50:908–17. CrossRef
- Prognostic importance of home blood pressure measurement in patients with diabetic nephropathy
Volume 2, Issue 1 , pp 10-18
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Home blood pressure
- Diabetic nephropathy
- Type 2 diabetes
- Author Affiliations
- 1. Department of Internal Medicine, National Hospital Organization Chiba-East National Hospital, 673 Nitonachou, Chuou-ku, Chiba, Chiba, 260-8712, Japan
- 2. Hokkaido Medical Center, 5-7-1-1 Yamanote, Nishi-ku, Sapporo, Hokkaido, 063-0005, Japan
- 3. Chiba Medical Center, 4-1-2 Tsubakimori, Chuou-ku, Chiba, Chiba, 260-8606, Japan
- 4. Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan
- 5. Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan
- 6. Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kauchinagano, Osaka, 586-8521, Japan
- 7. Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, Okayama, 701-1192, Japan
- 8. Higashi-Tokushima Hospital, 1-1 Ootera Aza Oomukaikita, Itano Town, Itano, Tokushima, 779-0193, Japan
- 9. Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Fukuoka, 810-8563, Japan
- 10. Kumamoto Medical Center, 1-5 Ninomaru, Kumamoto, Kumamoto, 860-0008, Japan
- 11. University of Human Arts and Sciences, 1288 Magome, Iwatsuki-ku, Saitama, Saitama, 339-8539, Japan