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Predisposition to essential hypertension and development of diabetic nephropathy in IDDM patients.

  1. J A Fagerudd,
  2. L Tarnow,
  3. P Jacobsen,
  4. S Stenman,
  5. F S Nielsen,
  6. K J Pettersson-Fernholm,
  7. C Grönhagen-Riska,
  8. H H Parving and
  9. P H Groop
  1. Department of Medicine, Helsinki University Central Hospital, Finland.
    Diabetes 1998 Mar; 47(3): 439-444. https://doi.org/10.2337/diabetes.47.3.439
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    Abstract

    Conflicting results have been reported on the relationship between familial predisposition to hypertension and development of diabetic nephropathy in IDDM. In our case-control study, we assessed the prevalence of hypertension among parents of 73 IDDM patients with diabetic nephropathy (DN+; persistent albuminuria > 200 microg/min or > 300 mg/24 h) and 73 IDDM patients without diabetic nephropathy (DN-; urinary albumin excretion < 20 microg/min or < 30 mg/24 h). Arterial hypertension, defined as antihypertensive therapy or a 24-h ambulatory blood pressure (SpaceLabs 90207) > or = 135/85 mmHg, was present in 57% of parents of DN+ patients compared with 41% of parents of DN- patients (P = 0.034; difference 16% [95% CI 1.3-29.6%]). In addition, the cumulative incidence of hypertension was higher among parents of DN+ patients (log-rank test P < 0.001), with a shift toward younger age at onset of hypertension in this group. However, the difference in prevalence of parental hypertension was not evident using office blood pressure measurements (64 vs. 57%; NS; difference 7% [-5.8-20%). Furthermore, patients with DN+ and with antihypertensive therapy in both parents were themselves more frequently treated for hypertension than were patients with DN+ and without parental treatment for hypertension (100 vs. 61%; P = 0.034; difference 39% [21-57%]). In conclusion, familial predisposition to essential hypertension increases the risk of diabetic nephropathy and may also contribute to the development of systemic hypertension in patients with IDDM and diabetic nephropathy.

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    March 1998, 47(3)
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    Predisposition to essential hypertension and development of diabetic nephropathy in IDDM patients.
    J A Fagerudd, L Tarnow, P Jacobsen, S Stenman, F S Nielsen, K J Pettersson-Fernholm, C Grönhagen-Riska, H H Parving, P H Groop
    Diabetes Mar 1998, 47 (3) 439-444; DOI: 10.2337/diabetes.47.3.439

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    Predisposition to essential hypertension and development of diabetic nephropathy in IDDM patients.
    J A Fagerudd, L Tarnow, P Jacobsen, S Stenman, F S Nielsen, K J Pettersson-Fernholm, C Grönhagen-Riska, H H Parving, P H Groop
    Diabetes Mar 1998, 47 (3) 439-444; DOI: 10.2337/diabetes.47.3.439
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