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Journal of Diabetes Research
Volume 2016, Article ID 5876792, 6 pages
Research Article

Awaking Blood Pressure Surge and Progression to Microalbuminuria in Type 2 Normotensive Diabetic Patients

1Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy
2Evangelical Hospital Villa Betania, Naples, Italy
3Alzheimer’s Disease Clinic, ASL Frosinone, Atina, Italy

Received 3 November 2015; Revised 18 November 2015; Accepted 25 November 2015

Academic Editor: Bernard Portha

Copyright © 2016 Michelangela Barbieri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. We investigated the predictive value of morning blood pressure surge (MBPS) on the development of microalbuminuria in normotensive adults with a recent diagnosis of type 2 diabetes. Methods. Prospective assessments of 24-hour ambulatory blood pressure monitoring and urinary albumin excretion were performed in 377 adult patients. Multivariate-adjusted Cox regression models were used to assess hazard ratios (HRs) between baseline and changes over follow-up in MBPS and the risk of microalbuminuria. The MBPS was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP. Results. After a mean follow-up of 6.5 years, microalbuminuria developed in 102 patients. An increase in MBPB during follow-up was associated with an increased risk of microalbuminuria. Compared to individuals in the lowest tertile (− mmHg), the HR and 95% CI for microalbuminuria in those in the highest tertile of change ( mmHg) during follow-up were 17.41 (95% CI 6.26–48.42); for trend <0.001. Mean SD MBPS significantly increased in those who developed microalbuminuria from a mean [SD] of 10.6 to 36.8 , . Conclusion. An increase in MBPS is associated with the risk of microalbuminuria in normotensive adult patients with type 2 diabetes.