Raised arterial pressure in parents of proteinuric insulin dependent diabetics

• Published in: British Medical Journal (Clinical research ed.) Vol. 295; no. 6597; pp. 515 - 517
• Main Authors: Viberti, G C, Keen, H, Wiseman, M J
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 29.08.1987; British Medical Association; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Blood Pressure; Child; Clinical Research; Diabetes; Diabetes complications; Diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - physiopathology; Diabetic nephropathies; Diabetic Nephropathies - etiology; Diabetic Nephropathies - genetics; Female; Humans; Hypertension; Insulin; Male; Medical genetics; Middle Aged; Parents; Pressure dependence; Proteinuria - etiology; Proteinuria - genetics; Proteinuria - physiopathology; Risk Factors; Type 1 diabetes mellitus
• ISSN: 0267-0623; 1468-5833
• DOI: 10.1136/bmj.295.6597.515

Arterial pressure is raised early in the subset of insulin dependent diabetics at risk of later development of progressive renal failure, suggesting that liability to arterial hypertension may play a part in the aetiology of diabetic kidney disease. Evidence for a genetic basis was therefore sought by measuring the blood pressures of the 26 surviving parents of 17 insulin dependent diabetic patients with proteinuria and comparing them with those of the parents of 17 matched insulin dependent diabetic patients without proteinuria selected from the same cohort. Systolic and diastolic pressures were significantly higher in parents of the proteinuric (mean (SD) 161 (27)/94 (14) mm Hg) than in parents of the non-proteinuric patients (146 (21)/86 (11) mm Hg). The difference between the sample mean blood pressures was 15 mm Hg (95% confidence interval 3.3 to 26.7 mm Hg) for systolic pressure and 8 mm Hg (95% confidence interval 0.8 to 15.2 mm Hg) for diastolic pressure. These differences were independent of age, sex, and adiposity. There was a significant correlation between the mean arterial pressures in the proteinuric patients and the higher mean blood pressure in their parents. High blood pressure in non-diabetic parents may be a marker of susceptibility to clinical nephropathy in their insulin dependent diabetic offspring.