Abstract 16841: A New Proposal of the Cutoff Value of Home BP in Treated Type 2 Diabetes Patients - The J-HOP Study-

Abstract

Background: There is a controversy how low home BP be lowered in patients with type 2 diabetes.

Objectives: We sought to examine appropriate target home BP level in type 2 diabetes.

Methods: This is a subanalysis of the Japan Morning Surge - Home Blood Pressure (J-HOP) study. We enrolled 4002 patients who have at least one cardiovascular risk factor, and performed clinic and home BP monitoring. Home BP was calculated as the mean of morning and evening values for 14 days. The urinary albumin creatinine ratio (UACR) was measured and defined as a marker of microvascular disease. Quadratic equations of the relationship between clinic/home SBP and logUACR were used to determine the cutoff value of home BP. Values of UACR which correspond to clinic SBP 140 mmHg and 130 mmHg were determined, and home BP levels corresponding to these UACR values were calculated separately by the presence/absence of diabetes.

Results: The mean age was 65.0 ± 10.8 years; 46.0% were male; and 87% had hypertension. There were 903 (21.6%) patients with diabetes, and 3099 (77.4%) with non-diabetes. Figures show the scatterplots and quadratic curves of clinic and home SBP in diabetes/ non-diabetes. Home BP level equivalent to clinic SBP 140 mmHg was 132 mmHg in non-diabetes, and 135 mmHg in diabetes. On the other hand, home SBP equivalent to clinic SBP 130 mmHg was 128mmHg in diabetes.

Conclusions: Regardless of diabetic status, home BP level which corresponds to clinic SBP 140 mmHg was 135 mmHg. In patients with type 2 diabetes, home SBP 128 mmHg was equivalent BP level to clinic SBP 130mmHg with regard to the extent of microvascular disease. These results imply that target home SBP level should be 128 mmHg in patients with type 2 diabetes.