Document Detail


Masked hypertension, urinary albumin excretion rate, and echocardiographic parameters in putatively normotensive type 2 diabetic patients.
MedLine Citation:
PMID:  17303786     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the impact of masked hypertension in normotensive type 2 diabetic patients on microvascular complications and echocardiographic parameters. RESEARCH DESIGN AND METHODS: A cross-sectional study was conducted in 135 normotensive patients with type 2 diabetes. Patients underwent urinary albumin excretion rate (UAER) measurement, echocardiography, and 24-h ambulatory blood pressure monitoring (ABPM). Patients with increased daytime blood pressure levels (> or = 135/85 mmHg) were classified as having masked hypertension. RESULTS: The prevalence of masked hypertension was 30% (n = 41). Normotensive and masked hypertensive subjects, based on ambulatory blood pressure, were not different in terms of age, diabetes duration, smoking status, BMI, waist circumference, serum creatinine, glycemic, or lipid profiles. The office systolic blood pressure was higher in those with masked hypertension (127.8 +/- 7.5 vs. 122.9 +/- 10.2 mmHg, P = 0.003) than in the normotensive group. UAER also was increased in the group with masked hypertension (21.3 microg/min [range 2.5-1,223.5] vs. 8.1 microg/min [1.0-1,143.0], P = 0.001), as was the interventricular septum (1.01 +/- 0.15 vs. 0.94 +/- 0.13 cm, P = 0.015) and posterior wall (0.96 +/- 0.12 vs. 0.90 +/- 0.10 cm, P = 0.006) thickness. After adjustments for diabetes duration, sex, smoking, LDL cholesterol, and A1C values, all associations were sustained for daytime systolic blood pressure but not for office systolic blood pressure. CONCLUSIONS: Type 2 diabetic patients with masked hypertension have higher UAER as well as enlargement of ventricular walls compared with the normotensive patients, according to ABPM. Therefore, ABPM is important to identify this high-risk group so as to be able to take interventionist measures.
Authors:
Cristiane B Leitão; Luís H Canani; Caroline K Kramer; Juliana C Boza; Antônio F Pinotti; Jorge L Gross
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-02-15
Journal Detail:
Title:  Diabetes care     Volume:  30     ISSN:  1935-5548     ISO Abbreviation:  Diabetes Care     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-30     Completed Date:  2007-06-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1255-60     Citation Subset:  IM    
Affiliation:
Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. crisbleitao@yahoo.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Albuminuria / epidemiology*
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Brazil / epidemiology
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / physiopathology*,  urine
Diabetic Angiopathies / epidemiology,  physiopathology
Diabetic Nephropathies / epidemiology*,  physiopathology
Electrocardiography*
Female
Humans
Hypertension / epidemiology*,  physiopathology
Male
Middle Aged

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