Maximum morning home systolic blood pressure is an indicator of the development of diabetic nephropathy: The KAMOGAWA‐HBP study

• Main Authors: Takuro Okamura, Emi Ushigome, Nobuko Kitagawa, Chikako Oyabu, Toru Tanaka, Goji Hasegawa, Naoto Nakamura, Masayoshi Ohnishi, Sei Tsunoda, Hidetaka Ushigome, Isao Yokota, Masahide Hamaguchi, Mai Asano, Masahiro Yamazaki, Michiaki Fukui
• Format: Article
• Language: English
• Published: Wiley 2019-11-01
• Series: Journal of Diabetes Investigation
• Subjects: Diabetic nephropathy; Hypertension; Maximum home blood pressure
• Online Access: https://doi.org/10.1111/jdi.13040

Abstract Aims/Introduction The maximum value of home systolic blood pressure is correlated with damage to target organs, including diabetic nephropathy. However, the precise relationship between the development of diabetic nephropathy and maximum home systolic blood pressure has not been elucidated. Materials and Methods In this prospective 2‐year cohort subanalysis of the KAMOGAWA‐HBP study, the patient population was 477 Japanese patients with normoalbuminuria. We investigated the effects of mean and maximum home blood pressure on the development of diabetic nephropathy, which we defined as a urinary albumin excretion value ≥30 mg/g creatinine. Among the 477 patients, 67 developed diabetic nephropathy. Results In our multivariate logistic regression analyses, the maximum morning home systolic blood pressure was significantly positively associated with the development of diabetic nephropathy after adjusting for patient sex and age, smoking status, the diabetes mellitus duration, body mass index, creatinine, total cholesterol, hemoglobin A1c, and antihypertensive medication use (odds ratio 1.21, 95% confidence interval 1.03–1.42, P = 0.021). Conclusions Maximum home blood pressure can be identified at a glance, and its measurement would thus be helpful to healthcare providers who treat patients with diabetes and normoalbuminuria.