Longitudinal Analysis of Blood Pressure, Lipid, and Glycemic Control in Diabetic Patients With Nephropathy Attending a Hospital Outpatient Clinic and Their Relationship to Renal Function, Mortality, and Cardiovascular Morbidity

Clinical trials have shown that optimal blood pressure (BP) control slows the deterioration of renal function in diabetic nephropathy (1), with specific renoprotection from ACE inhibition therapy (2). The benefit of glycemic control is less well established (3). Studies have demonstrated the efficacy of lipid control in the primary and secondary prevention of coronary heart disease in diabetic and nondiabetic people (4,5). Therefore, it is important that patients with diabetic nephropathy use a multiple risk-factor approach (6). Few data are available on BP, lipid, and glycemic control in the nontrial setting. We recently audited the use of therapies proven beneficial in a high-risk group of diabetic patients with overt nephropathy and completed a retrospective analysis of putative renal-failure progression factors from 1992 to 1999. Data were extracted from our Diabetic Nephropathy Database (Microsoft Access 1997). Mean systolic BP (SBP), diastolic BP (DBP), HbA1c, total serum cholesterol (TC), …