January 1, 2008Journal of Clinical HypertensionOpen Access

Nocturnal Blood Pressure Elevation Predicts Progression of Albuminuria in Elderly People With Type 2 Diabetes

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Why the study?

Does a nocturnal blood pressure rise predict the progression of albuminuria in elderly patients with type 2 diabetes?

Population

957 older Medicare beneficiaries with type 2 diabetes mellitus, free of macroalbuminuria at baseline…

Comparison

Nocturnal blood pressure rise assessed by… vs Dippers and nondippers

Design

Cohort

Follow-up

mean 30.4 ± 9 months

Authors

WPWalter PalmasUniversity of Vermont TPThomas G. PickeringUniversity of Southern California JTJeanne A. TeresiColumbia University Irving Medical Center

Discussion

Member takes

Implication

May support ambulatory BP monitoring for risk stratification in elderly T2D; leaves open whether targeting nocturnal rise slows albuminuria progression.

Structured PICO

Does a nocturnal blood pressure rise predict the progression of albuminuria in elderly patients with type 2 diabetes?

Population

957 older Medicare beneficiaries (age ≥55 years) with type 2 diabetes mellitus, free of macroalbuminuria at baseline, residing in medically underserved areas of New York State.

Intervention

Nocturnal blood pressure rise (ratio of mean sleep to mean wake systolic BP >1.0) assessed by 24-hour ambulatory blood pressure monitoring

Comparator

Dippers (ratio ≤0.9) and nondippers (flat nocturnal pattern, ratio >0.9 to 1.0)

Outcome

Progression of albuminuria (persistent increase in albumin-to-creatinine ratio to a higher category) at up to 3 years follow-upsurrogate

In elderly patients with type 2 diabetes, a nocturnal rise in blood pressure on ambulatory monitoring independently predicts the progression of albuminuria, providing prognostic information beyond office and 24-hour pulse pressure.

Limitations

Observational design
Nonrandomized antihypertensive treatment assignment precludes unbiased assessment of medication classes

Cite This Study

Palmas et al. (2008) studied this question.

synapsesocial.com/papers/6a7e3099ef8e9536aa8561dc https://doi.org/10.1111/j.1524-6175.2007.07170.x

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Implication

May support ambulatory BP monitoring for risk stratification in elderly T2D; leaves open whether targeting nocturnal rise slows albuminuria progression.

Nocturnal Blood Pressure Elevation Predicts Progression of Albuminuria in Elderly People With Type 2 Diabetes

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Nocturnal Blood Pressure Elevation Predicts Progression of Albuminuria in Elderly People With Type 2 Diabetes

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider