Published Online
on April 3, 2006

A more recent version of this article appeared on May 1, 2006

This Article Full Text (PDF) All Versions of this Article: 47/5/955    most recent 01.HYP.0000216634.73504.7dv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moran, A. Articles by Shea, S. Search for Related Content PubMed PubMed Citation Articles by Moran, A. Articles by Shea, S. Related Collections Other hypertension Type 2 diabetes Clinical Studies Other diagnostic testing Epidemiology

Submitted on December 2, 2005
Revised on December 20, 2005

Office and Ambulatory Blood Pressure Are Independently Associated With Albuminuria in Older Subjects With Type 2 Diabetes

Andrew Moran; Walter Palmas; Thomas G. Pickering; Joseph E. Schwartz; Lesley Field; Ruth S. Weinstock; and Steven Shea^*

From the Department of Medicine (A.M.), University of California at San Francisco; General Internal Medicine Section (A.M.), San Francisco Veterans Affairs Medical Center, Calif; Department of Medicine (W.P., T.G.P., L.F., S.S.), Department of Biomedical Informatics (S.S.), and Behavioral Cardiovascular Health and Hypertension Program (T.G.P.), and Department of Epidemiology, Joseph Mailman School of Public Health (S.S.), Columbia University, New York, NY; Department of Psychiatry and Behavioral Science (J.E.S.), State University of New York at Stony Brook; Joslin Diabetes Center and Division of Endocrinology, Diabetes and Metabolism (R.S.W.), State University of New York Upstate Medical University, Syracuse; and Department of Veterans Affairs (R.S.W.), VA Medical Center, Syracuse.

^* To whom correspondence should be addressed. E-mail: ss35{at}columbia.edu.

Abstract--Blood pressure strongly predicts microalbuminuria and later progression to renal failure in people with diabetes. Ambulatory blood pressure monitoring seems to be superior to office blood pressure in predicting progression to microalbuminuria in type 1 diabetes. The associations of ambulatory blood pressure with office blood pressure and microalbuminuria in type 2 diabetes remain unclear. We studied the association of office blood pressure taken with an automated device and ambulatory blood pressure with spot urine albumin:creatinine ratio in 1180 older people with type 2 diabetes participating in the Informatics for Diabetes Education and Telemedicine Study. Office and awake systolic blood pressure were independently associated with albuminuria (P<0.001 for both) in a multivariate linear regression analysis that adjusted for age, gender, duration of diabetes, hemoglobin A1c, number of antihypertensive medications, and use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. Twelve percent of participants had well-controlled office blood pressure but not ambulatory blood pressure, whereas 14% had well-controlled ambulatory but not office blood pressure. The prevalence of microalbuminuria and macroalbuminuria in these subgroups was intermediate between those with well-controlled or uncontrolled blood pressure by both methods. We found, in a multiethnic group of older subjects with type 2 diabetes, that office systolic blood pressure and awake systolic ambulatory blood pressure exhibited independent associations with degree of albuminuria.

Key words: blood pressure monitoring, ambulatory • diabetes mellitus • elderly

This article has been cited by other articles:

				G. Parati and G. Bilo Should 24-h Ambulatory Blood Pressure Monitoring Be Done in Every Patient With Diabetes? Diabetes Care, November 1, 2009; 32(suppl_2): S298 - S304. [Full Text] [PDF]

				W. Palmas, T. G. Pickering, J. Teresi, J. E. Schwartz, A. Moran, R. S. Weinstock, and S. Shea Ambulatory Blood Pressure Monitoring and All-Cause Mortality in Elderly People With Diabetes Mellitus Hypertension, February 1, 2009; 53(2): 120 - 127. [Abstract] [Full Text] [PDF]

				M S O'Neill, A V Diez-Roux, A H Auchincloss, T G Franklin, D R Jacobs Jr, B C Astor, J T Dvonch, and J Kaufman Airborne particulate matter exposure and urinary albumin excretion: the Multi-Ethnic Study of Atherosclerosis Occup. Environ. Med., August 1, 2008; 65(8): 534 - 540. [Abstract] [Full Text] [PDF]

				W. Palmas, A. Moran, T. Pickering, J. P. Eimicke, J. Teresi, J. E. Schwartz, L. Field, R. S. Weinstock, and S. Shea Ambulatory Pulse Pressure and Progression of Urinary Albumin Excretion in Older Patients With Type 2 Diabetes Mellitus Hypertension, August 1, 2006; 48(2): 301 - 308. [Abstract] [Full Text] [PDF]