Document Detail

Usefulness of home blood pressure measurement in the morning in patients with type 2 diabetes: long-term results of a prospective longitudinal study.
MedLine Citation:
PMID:  20504126     Owner:  NLM     Status:  MEDLINE    
Previous cross-sectional studies have demonstrated that blood pressure measurements at home (HBP) in the morning display stronger predictive power for micro- and macrovascular complications in type 1 and 2 diabetic patients than casual/clinic blood pressure (CBP) measurements. This longitudinal study investigated which of these measurements offers stronger predictive power for outcomes over 6 years. At baseline, 400 Japanese patients with type 2 diabetes were classified as hypertensive or normotensive based on HBP and CBP measurements. Mean (+/-SD) survey duration of all patients was 42.1 +/- 20.0 months (range, 3-72 months). Primary and secondary endpoints were death and new, worsened, or improved micro- and macrovascular events, respectively. Differences in outcomes for each endpoint between hypertensive and normotensive patients in each group were analyzed using survival curves from Kaplan-Meier analysis and log-rank testing. Associated risk factors related to outcomes were assessed using Cox proportional hazards modeling. On the basis of HBP, cumulative events of death and new or worsened microvascular diseases were significantly higher in hypertensive patients than in normotensive patients. On the basis of CBP, no significant differences were identified. New or worsened macrovascular events were significantly higher in hypertensive patients than in normotensive patients on the basis of both HBP and CBP. One associated risk factor was morning hypertension. A longitudinal study of type 2 diabetic patients demonstrated that elevated HBP in the morning is predictive of micro- and macrovascular complications.
Kyuzi Kamoi; Takako Ito; Masashi Miyakoshi; Shinichi Minagawa
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Clinical and experimental hypertension (New York, N.Y. : 1993)     Volume:  32     ISSN:  1525-6006     ISO Abbreviation:  Clin. Exp. Hypertens.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-27     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9305929     Medline TA:  Clin Exp Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  184-92     Citation Subset:  IM    
Center of Diabetes and Endocrine & Metabolism Disease, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan.
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MeSH Terms
Aged, 80 and over
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology*
Blood Pressure Determination / methods*
Cardiovascular Diseases / epidemiology
Coronary Disease / epidemiology
Diabetes Mellitus, Type 2 / complications,  epidemiology,  physiopathology*
Diabetic Nephropathies / epidemiology
Diabetic Retinopathy / epidemiology
Hypertension / complications,  epidemiology,  physiopathology*
Hypoglycemic Agents / therapeutic use
Kaplan-Meiers Estimate
Longitudinal Studies
Middle Aged
Proportional Hazards Models
Prospective Studies
Risk Factors
Treatment Outcome
Reg. No./Substance:
0/Antihypertensive Agents; 0/Hypoglycemic Agents

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