Elevated BP Tied to Albuminuria in Elderly Diabetics

Office and ambulatory blood pressure are independently associated with albuminuria in older patients with type 2 diabetes.

Lead investigator Dr. Andrew Moran states that, "patients with diabetes and high blood pressure have a higher risk of heart and kidney disease compared to patients with high blood pressure alone. Both diabetes and high blood pressure lead to elevated urine protein measurements — albuminuria — that is a marker for increased risk for heart and kidney disease."

Dr. Moran of the University of California at San Francisco, and colleagues studied 1180 ethnically diverse type 2 diabetes patients, with a mean age of 71 years. Their office blood pressures were compared with their ambulatory blood pressures, and spot urine albumin:creatinine ratio was determined using samples taken at examination.

"We showed that elevated 24-hour blood pressure measurements were associated with higher urine protein in older patients with diabetes — even after taking into account their office blood pressures," Dr. Moran said.

Moreover, "12% of the diabetic patients in our study had high 24-hour blood pressure measurements while their clinic blood pressures were normal." Conversely, "14% had well-controlled ambulatory but not office blood pressure," the investigators report in the May issue of Hypertension.

These results, he added, "suggest that 24-hour blood pressure monitoring may identify diabetic patients who require improved blood pressure control, despite normal range clinic blood pressures."

Dr. Moran pointed out that the findings should be interpreted with caution "because they are cross-sectional — that is — all measurements were done at the same time."

Hypertension 2006;47:955-961.

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