Usefulness of Home Blood Pressure Measurement in the Morning in Type 2 Diabetic Patients

• Published in: Diabetes care Vol. 25; no. 12; pp. 2218 - 2223
• Main Authors: KAMOI, Kyuzi, MIYAKOSHI, Masashi, SODA, Satoshi, KANEKO, Susumu, NAKAGAWA, Osamu
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.12.2002
• Subjects: Aged; Associated diseases and complications; Biological and medical sciences; Blood pressure; Blood Pressure - physiology; Blood Pressure Determination - methods; Body Mass Index; Cardiovascular Diseases - epidemiology; Circadian Rhythm; Complications and side effects; Coronary Disease - epidemiology; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - epidemiology; Diabetic Nephropathies - epidemiology; Diabetic Retinopathy - epidemiology; Disease management; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Hypertension - epidemiology; Hypoglycemic Agents - therapeutic use; Lipids - blood; Male; Management. Various non-drug treatments. Langerhans islet grafts; Measurement; Medical sciences; Middle Aged; Monitoring, Physiologic - methods; Prevalence; Self Care; Type 2 diabetes; Asia; Japan; Endocrinopathy; Kidney disease; Human; Hypertension; Nervous system diseases; Urinary system disease; Statistical analysis; Retinopathy; Diabetes mellitus; Morning; Cardiovascular disease; Coronary heart disease; Non insulin dependent diabetes; Biological monitoring; Cerebral disorder; Eye disease; Nephropathy; Central nervous system disease; At home; Complication; Predictive factor; Fast; Cerebrovascular disease; Glycemia
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.25.12.2218

Usefulness of Home Blood Pressure Measurement in the Morning in Type 2 Diabetic Patients Kyuzi Kamoi , MD 1 , Masashi Miyakoshi , MD 1 , Satoshi Soda , MD 1 2 , Susumu Kaneko , MD 1 2 and Osamu Nakagawa , MD 2 1 Department of Medicine, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan 2 Division of Endocrinology/Metabolism, Niigata University Graduate School of Medical & Dental Sciences, Niigata, Japan Abstract OBJECTIVE —Recently, repeated home blood pressure (HBP) measurements in the morning for a long period have been shown to have a stronger predictive power for mortality in patients with hypertension than occasional casual/clinic blood pressure (CBP) measurements. We studied whether HBP in the morning in type 2 diabetic patients is useful for prediction of diabetic complications. RESEARCH DESIGN AND METHODS —The occurrence of diabetic complications (nephropathy, retinopathy, coronary heart disease [CHD], and cerebrovascular disease [CVD]) were examined in relation to morning HBP as well as to CBP in 170 type 2 diabetic patients treated with antidiabetic and antihypertensive drugs. Blood pressure was measured at the clinic during the day and at home after awakening in the morning. Clinic hypertension (CH) and morning hypertension (MH) were defined as systolic blood pressure (SBP) ≥130 mmHg and/or diastolic blood pressure (DBP) ≥85 mmHg. The relation of CH and MH to the prevalence of these events was examined. RESULTS —There were no significant differences in the prevalence of nephropathy, retinopathy, CHD, and CVD between the two groups with ( n = 131) and without CH ( n = 39), whereas the prevalences of these events in the patients with MH ( n = 97) were significantly higher ( P < 0.05) than in those without MH ( n = 73). The prevalence of nephropathy was highly associated with systolic MH. CONCLUSIONS —Elevations of HBP in the morning in diabetic patients are strongly related to microvascular and macrovascular complications, especially nephropathy. It is concluded that the control of MH may prevent vascular complications in type 2 diabetic patients. CBP, clinic blood pressure CH, clinic hypertension CHD, coronary heart disease CN, clinic normotension CVD, cerebrovascular disease DBP, diastolic blood pressure HBP, home blood pressure MH, morning hypertension MN, morning normotension ROC, receiver operating characteristic SBP, systolic blood pressure Footnotes Address correspondence and reprint requests to Kyuzi Kamoi, MD, Department of Medicine, Nagaoka Red Cross Hospital, Nagaoka, Niigata, 940-2085, Japan. E-mail: kkam-int{at}echigo.ne.jp . Received for publication 25 February 2002 and accepted in revised form 23 August 2002. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. DIABETES CARE