Microalbuminuria is Associated with Morning Hypertension in Hypertensive Patients with Glucose Intolerance

摘要

Objective It is thought that morning blood pressure (BP) measurements at home are an important independent predictive factor of cerebrovascular and cardiovascular incidents. In addition, it is said that the appearance of microalbuminuria is a predictive factor of cardiovascular incidents. In this study, we investigated the association between microalbuminuria and morning BP at home. Methods Subjects who had received medical treatment for hypertension in our outpatient clinic from October to December 2007 were enrolled. Of the 380 patients studied, which subjects gave informed consent for this study,122 (32.1% ； 59 men, 63 women) showed glucose intolerance (fasting blood sugar (BS) >=110 mg/dL and/or HbA1c>=5.8%) and 91(41men, 50 women) brought their home BP records to the outpatient clinic (74.6%). We examined the association between microalbuminuria and morning BP in these 91 patients. Results There were 41 male patients (64.9 +-10.8 years old) and 50 female patients (67.0 +-9.1 years old). Logistic analysis showed that age [odds ratio (OR) =1.04 ； 95% confidence interval (CI)：1.00-1.07 ； p<0.01],SBP at the outpatient clinic (OR = 0.94 ； 95%CI ： 0.92-0.97;<0.01)， sex (OR=0,96 ； 95%CI ： 0.71-1.29;p= 0.02) and microalbuminuria (OR= 1.69 ； 95% CI ：1.04-2.80 ；p< 0.01) were independent factors contributing to morning hypertension measurements at home. Conclusion The contributing factors determining morning hypertension were ： male gender, higher age, higher SBP at the outpatient clinic, and positive microalbuminuria. Microalbuminuria is known as a marker of disorders throughout the body. It is necessary to recommend more aggressive BP control for individuals with morning hypertension and glucose intolerance.