Prognostic significance of home pulse pressure for progression of diabetic nephropathy: KAMOGAWA-HBP study
| Autor: | Isao Yokota, Muhei Tanaka, Michiaki Fukui, Chikako Oyabu, Masahiro Yamazaki, Mai Asano, Hidetaka Ushigome, Shinobu Matsumoto, Noriyuki Kitagawa, Emi Ushigome |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Physiology Blood Pressure Type 2 diabetes 030204 cardiovascular system & hematology Gastroenterology Cohort Studies Diabetic nephropathy 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Internal Medicine Humans Medicine Diabetic Nephropathies Prospective Studies 030212 general & internal medicine Risk factor Prospective cohort study Aged business.industry Blood Pressure Determination Odds ratio Blood Pressure Monitoring Ambulatory Middle Aged Prognosis medicine.disease Pulse pressure Blood pressure Diabetes Mellitus Type 2 ROC Curve Disease Progression Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Hypertension Research. 41:363-371 |
| ISSN: | 1348-4214 0916-9636 |
| DOI: | 10.1038/s41440-018-0024-6 |
| Popis: | Pulse pressure (PP) has been noted as a potential independent risk factor for micro and macrovascular diabetic complications. We aimed to examine the prognostic value of home-measured PP (home PP) in patients with type 2 diabetes. This study is a 2-year prospective cohort study of 737 patients with type 2 diabetes. Home blood pressure measurements were performed for 14 consecutive days. We defined the progression of diabetic nephropathy as when the diabetic nephropathy stage advanced to a higher stage during the 2 years. Using logistic regression analyses, we investigated the relationship between home PP and home systolic blood pressure (SBP) in the morning and in the evening and the progression of diabetic nephropathy. Furthermore, we measured the area under the receiver-operating characteristic curve (AUC) to assess the predictive ability of the progression of diabetic nephropathy of home PP. During the 2-year study, progression of diabetic nephropathy was observed in 94 patients. The adjusted odds ratios (95% confidence interval (CI)) of home PP and home SBP to the progression of diabetic nephropathy were 1.23 (1.01-1.49) and 1.14 (0.98-1.33), respectively. The AUC (95% CI) of home PP to the progression of diabetic nephropathy was 0.624 (0.665-0.679). The optimal cut-off points, sensitivity and specificity for home PP that were associated with the progression of diabetic nephropathy were 57.7 mmHg, 0.649 and 0.580, respectively. Our findings suggest, for the first time, that home PP is an independent predictor of the progression of diabetic nephropathy in patients with type 2 diabetes. |
| Databáze: | OpenAIRE |
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