Document Detail


Controlling evening BP as well as morning BP is important in hypertensive patients with prediabetes/diabetes: the JMS-1 study.
MedLine Citation:
PMID:  20168303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The significance of home blood pressure (BP) measurement in type 2 diabetes (T2DM) has not been well investigated. We aimed to test the hypotheses that home BP is more closely associated with target-organ damage than clinic BP, and that the presence of prediabetes/T2DM enhances the impact of home BP measurement.
METHODS: We studied 551 hypertensives (99 diabetics and 452 nondiabetics) whose self-measured systolic BP (SBP) was >135 mm Hg while on medication. The subjects were followed for 6 months after allocation to either a control group or an active treatment group. The changes in clinic BP and home BP were analyzed in relation to the changes in the spot urine albumin-creatinine ratio (UAR).
RESULTS: The extent of clinic and home BP reduction was similar between the diabetic and nondiabetic groups. The change in UAR in nondiabetics was significantly associated with the extent of SBP reduction in the clinic (r = 0.19), morning (r = 0.33), and evening (r = 0.22, all P < 0.01). In contrast, in the diabetic group, the change in UAR was significantly associated with the changes in morning SBP (r = 0.23, P = 0.02) and evening SBP (r = 0.39, P < 0.001), but not with clinic BP. The correlation with evening SBP in the diabetic group tended to be stronger than the nondiabetic group.
CONCLUSIONS: In hypertensives with prediabetes/T2DM, changes in home BP were better than changes in clinic BP to predict changes in UAR. In particular, this suggests the hypothesis that aggressive control of evening home BP might be equally or more important to morning BP in hypertensives with prediabetes/T2DM.
Authors:
Kazuo Eguchi; Yoshio Matsui; Seiichi Shibasaki; Satoshi Hoshide; Tomoyuki Kabutoya; Joji Ishikawa; Shizukiyo Ishikawa; Kazuyuki Shimada; Kazuomi Kario;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-02-18
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-07-22     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  522-7     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. ke112@jichi.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Albuminuria / urine
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory*
Cardiovascular Diseases / epidemiology
Circadian Rhythm / physiology*
Creatinine / urine
Diabetes Mellitus, Type 2 / physiopathology*
Female
Follow-Up Studies
Humans
Hypertension / drug therapy,  physiopathology*
Japan
Male
Middle Aged
Prediabetic State / physiopathology*
Predictive Value of Tests
Risk Factors
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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