Effect of home blood pressure on inducing remission/regression of microalbuminuria in patients with type 2 diabetes mellitus

Motonobu Nishimura, Yasuhisa Kato, Tsuyoshi Tanaka, Hideki Taki, Atsuhito Tone, Kazunori Yamada, Seiji Suzuki, Miho Saito, Yutaka Ando, Yoshiharu Hoshiyama

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND The Home Blood Pressure for Diabetic Nephropathy study is a prospective observational study conducted to determine the effect of home blood pressure (HBP) on remission/regression of microalbuminuria in patients with type 2 diabetes mellitus (DM). METHODS Patients with type 2 DM having microalbuminuria were followed-up for 3 years. Remission of microalbuminuria was defined as shift from microalbuminuria to normoalbuminuria. Regression of microalbuminuria was defined as a 50% reduction in urinary albumin-creatinine ratio from baseline. All measurements of morning and evening HBP were averaged every year and defined as all HBP. RESULTS In total, 235 patients were followed up. The 3-year cumulative incidences of remission and regression were 32.3% and 44.7%, respectively. Following analysis of all cases, the degree of decline in all home systolic blood pressure (AHSBP), rather than mean AHSBP, influenced the incidence of remission/regression. There was a strong relationship between the decline in AHSBP during the follow-up period and AHSBP at baseline. Therefore, separate analyses of the patients with AHSBP below 140 mm Hg at baseline were performed, which revealed that mean AHSBP during the follow-up period independently affected the incidence of remission/ regression. The hazard ratio for inducing remission/regression was significantly lower in patients with AHSBP during the follow-up period above 130 mm Hg than in those with AHSBP below 120 mm Hg. CONCLUSIONS Optimal AHSBP for the induction of remission/regression of microalbuminuria might be below 130 mm Hg. It is required to confirm whether keeping AHSBP below 130 mm Hg leads to subsequent renoprotection or not.

Original languageEnglish
Pages (from-to)830-839
Number of pages10
JournalAmerican Journal of Hypertension
Volume30
Issue number8
DOIs
Publication statusPublished - 2017

    Fingerprint

Keywords

  • Blood pressure
  • Diabetic nephropathy
  • Home blood pressure
  • Hypertension
  • Microalbuminuria
  • Regression
  • Remission

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Nishimura, M., Kato, Y., Tanaka, T., Taki, H., Tone, A., Yamada, K., Suzuki, S., Saito, M., Ando, Y., & Hoshiyama, Y. (2017). Effect of home blood pressure on inducing remission/regression of microalbuminuria in patients with type 2 diabetes mellitus. American Journal of Hypertension, 30(8), 830-839. https://doi.org/10.1093/ajh/hpx050