Controlling evening BP as well as morning BP is important in hypertensive patients with prediabetes\diabetes: The jms-1 study

Kazuo Eguchi, Yoshio Matsui, Seiichi Shibasaki, Satoshi Hoshide, Tomoyuki Kabutoya, Joji Ishikawa, Shizukiyo Ishikawa, Kazuyuki Shimada, Kazuomi Kario

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

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.MethodsWe studied 551 hypertensives (99 diabetics and 452 nondiabetics) whose self-measured systolic BP (SBP) was 135mmHg 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).ResultsThe 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.ConclusionsIn 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.

Original languageEnglish
Pages (from-to)522-527
Number of pages6
JournalAmerican Journal of Hypertension
Volume23
Issue number5
DOIs
StatePublished - May 2010
Externally publishedYes

Keywords

  • Blood pressure
  • Evening blood pressure
  • Home blood pressure
  • Hypertension
  • Morning blood pressure
  • Type 2 diabetes
  • Urine albumin-creatinine ratio

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