Association of Microalbuminuria With Brachial-Ankle Pulse Wave Velocity: The Ohasama Study

Ishikawa, Tomofumi; Hashimoto, Junichiro; Morito, Rieko H.; Hanazawa, Tomohiro; Aikawa, Tomoyuki; Hara, Azusa; Shintani, Yoriko; Metoki, Hirohito; Inoue, Ryusuke; Asayama, Kei; Kikuya, Masahiro; Ohkubo, Takayoshi; Totsune, Kazuhito; Hoshi, Hiroyuki; Satoh, Hiroshi; Imai, Yutaka

doi:10.1038/ajh.2007.77

Cited by 39 publications

(51 citation statements)

References 29 publications

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“…In addition, there was a significant correlation between urinary protein excretion and baPWV. Recent studies have shown urinary protein excretion to be more closely associated with baPWV than with ambulatory BP level, 40 and that baPWV increased with a decrease in renal function or with proteinuria independently of other risk factors, 41 thereby supporting the results of this study.…”

Section: Discussionsupporting

confidence: 84%

Effects of angiotensin II type 1 receptor blocker on ambulatory blood pressure variability in hypertensive patients with overt diabetic nephropathy

et al. 2009

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Previous studies have shown increases in ambulatory short-term blood pressure (BP) variability to be related to cardiovascular disease. In this study, we examined whether the angiotensin II type 1 receptor blocker (ARB) would improve ambulatory shortterm BP variability in hypertensive patients with diabetic nephropathy. A total of 30 patients with type II diabetes, along with hypertension and overt nephropathy, were enrolled in this randomized, two-period, crossover trial of 12 weeks of treatment with losartan (50 mg daily) and telmisartan (40 mg daily). At baseline and at the end of each treatment period, 24-h ambulatory BP monitoring with power spectral analysis of heart rate and measurements of proteinuria, estimated glomerular filtration rate and brachial-ankle pulse wave velocity (baPWV) were performed. After 12 weeks of treatment, 24-h, daytime and nighttime shortterm BP variability, assessed on the basis of the coefficient of variation of ambulatory BP, was significantly decreased by telmisartan. Both losartan and telmisartan reduced urinary protein excretion and baPWV. However, compared with losartan, telmisartan significantly decreased urinary protein excretion, baPWV and low-frequency (LF)-to-high-frequency (HF) ratio, an index of sympathovagal balance. Multiple regression analysis showed significant correlations between urinary protein excretion and baPWV, 24-h LF-to-HF ratio, nighttime systolic BP and 24-h short-term systolic BP variability. These results suggest that ARB, particularly telmisartan, is effective in reducing proteinuria in hypertensive patients with overt diabetic nephropathy, partly through inhibitory effects on ambulatory short-term BP variability and sympathetic nerve activity, in addition to its longer duration of action on nighttime BP reduction.

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Section: Discussionsupporting

confidence: 84%

Effects of angiotensin II type 1 receptor blocker on ambulatory blood pressure variability in hypertensive patients with overt diabetic nephropathy

et al. 2009

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“…Comparisons have often examined the issues of whether ambulatory, office, day or night time BPs were similar determinants of nephropathies. [24][25][26][27] Few studies have directly compared different BP variables from the same measurements for the prediction of nephropathy, including in people with diabetes. These studies have generally emphasized the importance of SBP over DBP in promoting the development and progression of diabetic nephropathy.…”

Section: Discussionmentioning

confidence: 99%

Prolonged elevated postprandial sugar augments severity in kidney disease: a North Indian hospital-based study

Singh

Das

et al. 2013

Renal Failure

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Aim: Diabetes plays a major role in progression of renal failure. The risk-factor profile changes during the progression of chronic kidney disease (CKD) from mild/moderate to end-stage renal disease. The relationship between glycemic indices, blood pressure, body mass index (BMI) and age at diagnosis in Indians has been less investigated. We assessed association of these risk factors with CKD stages in Indian population. Methods: This study was carried out on patients (n ¼ 162) who were diagnosed with CKD and normal control group (n ¼ 155). For BMI, National Institutes for Health criteria were used to categorize the patients. Result: The mean age of CKD patients were significantly increased with the advancement of stage. BMI, systolic blood pressure (SBP), postprandial sugar level (PP), urea and creatinine were also significantly higher with elevated stages, whereas no differences were observed in diastolic blood pressure (DBP) and fasting blood sugar (FBS). The logistic regression study gave a significant result (p ¼ 0.000) when we compared the group of CKD patients with established/prolonged postprandial blood sugar. It was independently associated with mild CKD [odds ratio (OR) ¼ 5.213, 95% confidence interval (CI) ¼ 2.06-13.21, p ¼ 0.000], moderate CKD (OR ¼ 7.724, 95% CI ¼ 4.05-14.74, p ¼ 0.000) and severe CKD (OR ¼ 7.610, 95% CI ¼ 4.03-14.36, p ¼ 0.000). Conclusion: SBP and PP were the best predictors of prevalent nephropathy in this population, while DBP and FBS were found to be less effective. This may have implication for kidney disease risk stratification and protection.

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“…15 --18 Microalbuminuria is associated with increased baPWV in the general population, 16 and an increase in baPWV predicts the development of microalbuminuria in patients with hypertension. 18 The present findings are consistent with these previous studies and have extended them to a population with normal albuminuria.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with brachial-ankle pulse wave velocity in the general population

et al. 2011

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The present study investigated factors that modify or affect arterial stiffness as assessed by brachial-ankle pulse wave velocity (baPWV) in the general population. Subjects had previously participated in a physical checkup program (n ¼ 911), and baPWV and urinary albumin and sodium excretion were also measured. Urine albumin was expressed as the ratio of urine albumin to urine creatinine. Individual salt intake was assessed by estimating 24-h urinary salt excretion and expressed as the ratio of estimated salt intake to body weight. The mean blood pressure and baPWV were 127.1±15.2/77.0±9.5 mm Hg and 15.9±3.3 m s À1 , respectively. Univariate analysis demonstrated that baPWV correlated with various factors including age, blood pressure, electrocardiogram voltage (SV 1 þ RV 5 ), urine albumin and salt intake. Multivariate regression analysis revealed that electrocardiogram voltage (Po0.001), systolic blood pressure (Po0.0001), urine albumin (Po0.001) and salt intake (Po0.001), independently correlated with baPWV after adjustment for other possible factors. Similar results were obtained for participants not taking any medication. These results suggest that the baPWV value is independently associated with individual salt intake and cardiac and renal damage, and could be a useful procedure for identifying individuals with concealed risk of cardiovascular disease.

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Association of Microalbuminuria With Brachial-Ankle Pulse Wave Velocity: The Ohasama Study

Abstract: Microalbuminuria appears to be associated with baPWV more closely than with IMT and ABP, and its association with baPWV is independent of ABP and other cardiovascular risk factors.

Cited by 39 publications

References 29 publications

Effects of angiotensin II type 1 receptor blocker on ambulatory blood pressure variability in hypertensive patients with overt diabetic nephropathy

Effects of angiotensin II type 1 receptor blocker on ambulatory blood pressure variability in hypertensive patients with overt diabetic nephropathy

Prolonged elevated postprandial sugar augments severity in kidney disease: a North Indian hospital-based study

Factors associated with brachial-ankle pulse wave velocity in the general population

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