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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2006-7-21
pubmed:abstractText
We studied whether ambulatory blood pressure monitoring added to office blood pressure in predicting progression of urine albumin excretion over 2 years of follow-up in a multiethnic cohort of older people with type-2 diabetes mellitus. Participants in the Informatics for Diabetes Education and Telemedicine study underwent a baseline evaluation that included office and 24-hour ambulatory blood pressure measurement and a spot urine measurement of albumin-to-creatinine ratio (ACR). Measurements of albumin-to-creatinine ratio were repeated 1 and 2 years later. In bivariate analyses, ambulatory 24-hour pulse pressure was the blood pressure variable most strongly associated with follow-up ACR. Repeated-measures mixed linear models (n = 1040) were built adjusting for baseline ACR ratio, clustered randomization, time to follow-up, and multiple covariates. When both were entered into the model, ambulatory 24-hour pulse pressure and office pulse pressure were independently associated with follow-up ACR (beta [SE] = 0.010 [0.002], P < 0.001, and 0.004 [0.001], P = 0.002, respectively). Cox proportional hazards models examined associations with progression of albuminuria in 954 participants without macroalbuminuria at baseline, adjusting for all of the covariates independently associated with follow-up ACR in mixed linear models. Ambulatory 24-hour pulse pressure, but not office pulse pressure, was independently associated with progression of albuminuria (P = 0.015 and 0.052, respectively). The adjusted hazards ratio (95% CI) per each 10-mm Hg increment in ambulatory pulse pressure was 1.23 (1.04 to 1.42). In conclusion, ambulatory pulse pressure may provide additional information to predict progression of albuminuria in elderly diabetic subjects above and beyond office blood pressure.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
1524-4563
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
48
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
301-8
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16818800-Aged, pubmed-meshheading:16818800-Albuminuria, pubmed-meshheading:16818800-Blood Pressure, pubmed-meshheading:16818800-Blood Pressure Monitoring, Ambulatory, pubmed-meshheading:16818800-Cohort Studies, pubmed-meshheading:16818800-Comorbidity, pubmed-meshheading:16818800-Diabetes Mellitus, Type 2, pubmed-meshheading:16818800-Disease Progression, pubmed-meshheading:16818800-Female, pubmed-meshheading:16818800-Follow-Up Studies, pubmed-meshheading:16818800-Humans, pubmed-meshheading:16818800-Linear Models, pubmed-meshheading:16818800-Male, pubmed-meshheading:16818800-Medically Underserved Area, pubmed-meshheading:16818800-Multivariate Analysis, pubmed-meshheading:16818800-New York, pubmed-meshheading:16818800-Predictive Value of Tests, pubmed-meshheading:16818800-Proportional Hazards Models
pubmed:year
2006
pubmed:articleTitle
Ambulatory pulse pressure and progression of urinary albumin excretion in older patients with type 2 diabetes mellitus.
pubmed:affiliation
Division of General Medicine, Columbia University, New York, NY, USA. wp56@columbia.edu
pubmed:publicationType
Journal Article, Research Support, U.S. Gov't, Non-P.H.S.