Microalbuminuria in Patients with Non-Insulin-dependent Diabetes Mellitus Relates to Nocturnal Systolic Blood Pressure

• Published in: The American journal of medicine Vol. 102; no. 6; pp. 531 - 535
• Main Authors: Mitchell, Teresa H., Nolan, Beatrice, Henry, Mike, Cronin, Cornelius, Baker, Habib, Greely, Geraldine
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.1997; Elsevier; Elsevier Sequoia S.A
• Subjects: Adult; Aged; Albuminuria - etiology; Albuminuria - physiopathology; Biological and medical sciences; Blood Pressure; Case-Control Studies; Circadian Rhythm; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Middle Aged; Regression Analysis; Systole; Endocrinopathy; Human; Evaluation; Urinary system disease; Prognosis; Continuous; Albumin; Non insulin dependent diabetes; Cross sectional study; Arterial pressure; Predictive factor; Comparative study; Microalbuminuria; Pancreatic disease; Proteinuria
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/S0002-9343(97)00051-X

PURPOSE: Microalbuminuria predicts early mortality in non-insulin-dependent-diabetes mellitus patients (NIDDM). Our objective in the present study was to compare and assess the relationship between 24-hour, day and nocturnal ambulatory blood pressure (BP) and urinary albumin excretion rate (UAE) in microalbuminuric and normoalbuminuric NIDDM and in normal control subjects. PATIENTS AND METHODS: In the present cross-sectional study, 24 hour ambulatory BP (daytime BP and nocturnal BP) and HbA1c were compared in microalbuminuric (n = 10) and nonmicroalbuminuric NIDDM patients (n = 10) and in nondiabetic controls (n = 9). None of the patients were taking antihypertensive agents. RESULTS: In the microalbuminuric group, whereas 24 hour and daytime systolic BP differed significantly from control values (P <0.025 and P <0.05 respectively), there was no difference between diabetic groups. However, nocturnal systolic BP in the microalbuminuric group was significantly higher than in the normoalbuminuric diabetic patients (139 vs. 125) (P <0.05) and a significant difference was also found between the NIDDM patients and the control group (139, 125 vs. 114) (P <0.025). In multiple regression analysis, only nocturnal systolic BP showed a significant relationship with UAE (P <0.05). CONCLUSIONS: We suggest that the higher nocturnal systolic blood pressure seen in our microalbuminuric NIDDM patients may contribute to the increased morbidity in this group.