Item #7
Usefulness
of Home Blood Pressure Measurement in Type 2 Diabetic Patients
Elevations
of HBP in the morning in diabetic patients are strongly
related to microvascular and macrovascular complications.
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.
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.
The
study showed that t here 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 prevalence’s 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.
From
the results it was concluded that, e levations 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. Diabetes
Care 25:2218-2223, 2002
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