November 1, 1995Diabetes Care
Albuminuria and 24-h Ambulatory Blood Pressure in Normoalbuminuric and Microalbuminuric NIDDM Patients. A longitudinal study
Population
23 non-insulin-dependent diabetes mellitus patients receiving standard clinical care, and 8 healthy control…
Design
Cohort
Follow-up
mean 4.6 (range 4.2-5.1) years
Authors
Discussion
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Implication
May link rising ambulatory BP to albuminuria progression in diabetes; leaves open causal role and need for interventional trials.
Key Points
- To evaluate the longitudinal associations among 24-hour ambulatory blood pressure, urinary albumin excretion rate, and metabolic control in patients with non-insulin-dependent diabetes mellitus.
- Prospective longitudinal study following 23 patients with type 2 diabetes (11 normoalbuminuric and 12 microalbuminuric) receiving standard care and 8 healthy controls over a mean of 4.6 (range 4.2–5.1) years.
- Synchronously measured 24-hour ambulatory blood pressure (AMBP), urinary albumin excretion (UAE) rate, HbA1c, fasting plasma glucose, and serum creatinine at baseline and follow-up.
- Baseline systolic AMBP was significantly higher in diabetic patients compared with controls (146/80 [16/11] vs. 133/78 [9/9] mmHg, P < 0.05), but annual AMBP changes did not differ significantly between diabetic patients (0.6/-0.2 mmHg/year) and controls (0.7/0.2 mmHg/year).
- Annual changes in UAE correlated significantly with annual changes in systolic AMBP (r = 0.61, P < 0.002) and diastolic AMBP (r = 0.54, P < 0.008) across diabetic patients, driven by systolic AMBP in microalbuminuric patients (r = 0.71, P = 0.010) and diastolic AMBP in normoalbuminuric patients (r = 0.66, P = 0.026).
- Stepwise multiple linear regression identified annual progression of albuminuria as significantly determined by increases in systolic AMBP (parameter estimate 0.018, SE 0.006, P < 0.008) and diastolic AMBP (parameter estimate 0.026, SE 0.011, P < 0.033).
Structured PICO
P
Population
23 non-insulin-dependent diabetes mellitus (NIDDM) patients (11 with normoalbuminuria and 12 with microalbuminuria) receiving standard clinical care, and 8 healthy control subjects.
C
Comparator
Healthy control subjects
O
Outcome
Long-term relationships between 24-h ambulatory blood pressure (AMBP), urinary albumin excretion (UAE) rate, and metabolic controlsurrogate
In NIDDM patients, progression of albuminuria is significantly correlated with increases in both systolic and diastolic 24-h ambulatory blood pressure over time.
Cite This Study
Nielsen et al. (1995) studied this question.