In a nutshell
This study examined the association between blood pressure (BP) and the risk of kidney disease in patients with type 1 diabetes. They found that lower BP was associated with a lower risk of kidney complications.
Some background
It is recommended that adults with diabetes maintain a BP below 140/90 mmHg. This has been determined based on data from patients with type 2 diabetes. Studies involving patients with type 1 diabetes have suggested that BPs less than 110–120/70–80 mmHg were associated with a lower risk of some kidney complications. Studies have not focused on complications such as advanced chronic or end-stage kidney disease. The relationship between BP and these more advanced kidney problems in type 1 diabetes is not clear.
Methods & findings
This study included 1411 patients with type 1 diabetes. Patient age ranged from 13 to 39 years. Patients were separated into two groups depending on their blood glucose control strategy: intensive or conventional. Intensive control aimed for an HbA1c (average blood glucose over 3 months) of less than 6%. BP and urine albumin (a protein associated with kidney function) levels were measured at monthly and yearly intervals. Patients were followed for an average of 24 years.
Systolic BP of less than 120 mmHg was associated with a significantly lower risk of developing high levels of albumin in the urine and stage III chronic kidney disease. BP of 140/90 mmHg or more was associated with a significantly higher risk of these conditions. Blood glucose control strategy did not contribute to the risk of kidney complications.
The bottom line
This study concluded that lower blood pressure is associated with a reduced risk of kidney complications in type 1 diabetes patients. This was not influenced by blood glucose control strategy.
The fine print
The participants in this study were predominantly white (96%). This study is observational. Elevated BP may be a predictor of kidney disease but it may not cause it.
What’s next?
Discuss methods of blood pressure control with your physician.
Published By :
Diabetes Care
Date :
Nov 21, 2016
