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E-012 UNCONTROLLED HOME BLOOD PRESSURE IN THE MORNING IS ASSOCIATED WITH NEPHROPATHY IN JAPANESE PATIENTS WITH TYPE 2 DIABETES

Backgrounds Nephropathy in diabetic patients is the leading cause of end-stage renal failure. The significance of home blood pressure measurement has been widely recognized. In this study, we have investigated the state of blood pressure control level by measuring clinic and home blood pressure, and investigated the relationship between blood pressure control and nephropathy in Japanese patients with type 2 diabetes. Methods We measured clinic and home blood pressure in 923 patients with type 2 diabetes. According to the criteria for hypertension in the Japanese Society of Hypertension Guidelines 2009, patients were classified into four groups by clinic systolic blood pressure (130 mmHg) and morning systolic blood pressure (125 mmHg), as follows: controlled hypertension (CH), white-coat hypertension (WCH), masked hypertension (MH), and sustained hypertension (SH). Results Of all patients, 13.9%, 12.6%, 13.3% and 60.2% were identified as having CH, WCH, MH and SH, respectively. The average number of drugs prescribed was 1.8. Degree of urinary albumin excretion and the prevalence of nephropathy in diabetic patients were higher in MH and SH groups than those in CH group. The majority of patients had poor blood pressure control, regardless of ongoing conventional antihypertensive therapy, and diabetic patients with MH and SH were associated with nephropathy in diabetic patients. Conclusions More aggressive antihypertensive treatment is recommended to prevent nephropathy in patients with type 2 diabetes.