Nature of elevated blood pressure in normoalbuminuric type I diabetic patients. Essential hypertension?

Abstract

This study was undertaken to characterize type I diabetic patients with essential hypertension with respect to kidney function, renal hormones, and endothelial function. After 4 weeks without antihypertensive treatment, a cross-sectional study was carried out in the following groups: group 1, 14 healthy controls; group 2, 13 nondiabetic patients with essential hypertension (blood pressure > or = 140/90 mm Hg); group 3, 11 type I diabetic patients with hypertension but urinary albumin excretion (UAE) persistently normal (UAE: 10 mg/24 h, range 3 to 18) both before, during, and after discontinuing antihypertensive treatment; group 4, 15 type I diabetic patients with clinical nephropathy (UAE: 611 mg/24 h, range 192 to 3837) and hypertension. Systolic and diastolic blood pressures were similar in the three hypertensive groups: 147/96 +/- 8/6, 150/94 +/- 11/9, and 152/92 +/- 12/6 mm Hg (groups 2, 3, and 4, respectively) but elevated compared with controls (114/74 +/- 9/9 mm Hg, P < .001). The diabetic patients with essential hypertension were hyperfiltering in contrast to patients with nephropathy (glomerular filtration rate 114 +/- 23 v 90 +/- 21 mL/min/173 m2, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)