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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Aug 29;295(6597):515–517. doi: 10.1136/bmj.295.6597.515

Raised arterial pressure in parents of proteinuric insulin dependent diabetics.

G C Viberti 1, H Keen 1, M J Wiseman 1
PMCID: PMC1247425  PMID: 3117203

Abstract

Arterial pressure is raised early in the subset of insulin dependent diabetics at risk of later development of progressive renal failure, suggesting that liability to arterial hypertension may play a part in the aetiology of diabetic kidney disease. Evidence for a genetic basis was therefore sought by measuring the blood pressures of the 26 surviving parents of 17 insulin dependent diabetic patients with proteinuria and comparing them with those of the parents of 17 matched insulin dependent diabetic patients without proteinuria selected from the same cohort. Systolic and diastolic pressures were significantly higher in parents of the proteinuric (mean (SD) 161 (27)/94 (14) mm Hg) than in parents of the non-proteinuric patients (146 (21)/86 (11) mm Hg). The difference between the sample mean blood pressures was 15 mm Hg (95% confidence interval 3.3 to 26.7 mm Hg) for systolic pressure and 8 mm Hg (95% confidence interval 0.8 to 15.2 mm Hg) for diastolic pressure. These differences were independent of age, sex, and adiposity. There was a significant correlation between the mean arterial pressures in the proteinuric patients and the higher mean blood pressure in their parents. High blood pressure in non-diabetic parents may be a marker of susceptibility to clinical nephropathy in their insulin dependent diabetic offspring.

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Selected References

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  1. Barnett A. H., Mijovic C., Fletcher J., Chesner I., Kulkuska-Langlands B. M., Holder R., Bradwell A. R. Low plasma C4 concentrations: association with microangiopathy in insulin dependent diabetes. Br Med J (Clin Res Ed) 1984 Oct 13;289(6450):943–945. doi: 10.1136/bmj.289.6450.943. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bianchi G., Cusi D., Guidi E. Renal hemodynamics in human subjects and in animals with genetic hypertension during the prehypertensive stage. Am J Nephrol. 1983 Mar-Jun;3(2-3):73–79. doi: 10.1159/000166695. [DOI] [PubMed] [Google Scholar]
  3. Christiansen J. S., Gammelgaard J., Frandsen M., Parving H. H. Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetics. Diabetologia. 1981 Apr;20(4):451–456. doi: 10.1007/BF00253406. [DOI] [PubMed] [Google Scholar]
  4. Deckert T., Poulsen J. E. Diabetic nephropathy: fault or destiny? Diabetologia. 1981 Sep;21(3):178–183. doi: 10.1007/BF00252651. [DOI] [PubMed] [Google Scholar]
  5. Drury P. L. Diabetes and arterial hypertension. Diabetologia. 1983 Jan;24(1):1–9. doi: 10.1007/BF00275938. [DOI] [PubMed] [Google Scholar]
  6. Haffner S. M., Stern M. P., Hazuda H. P., Pugh J., Patterson J. K. Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin-dependent diabetes mellitus, lipids, and lipoproteins. Diabetes. 1987 Jan;36(1):43–51. doi: 10.2337/diab.36.1.43. [DOI] [PubMed] [Google Scholar]
  7. Hilton P. J. Cellular sodium transport in essential hypertension. N Engl J Med. 1986 Jan 23;314(4):222–229. doi: 10.1056/NEJM198601233140407. [DOI] [PubMed] [Google Scholar]
  8. Keen H., Track N. S., Sowry G. S. Arterial pressure in clinically apparent diabetics. Diabete Metab. 1975 Sep;1(3):159–178. [PubMed] [Google Scholar]
  9. Krolewski A. S., Warram J. H., Christlieb A. R., Busick E. J., Kahn C. R. The changing natural history of nephropathy in type I diabetes. Am J Med. 1985 May;78(5):785–794. doi: 10.1016/0002-9343(85)90284-0. [DOI] [PubMed] [Google Scholar]
  10. Mathiesen E. R., Oxenbøll B., Johansen K., Svendsen P. A., Deckert T. Incipient nephropathy in type 1 (insulin-dependent) diabetes. Diabetologia. 1984 Jun;26(6):406–410. doi: 10.1007/BF00262210. [DOI] [PubMed] [Google Scholar]
  11. Mauer S. M., Steffes M. W., Azar S., Sandberg S. K., Brown D. M. The effects of Goldblatt hypertension on development of the glomerular lesions of diabetes mellitus in the rat. Diabetes. 1978 Jul;27(7):738–744. doi: 10.2337/diab.27.7.738. [DOI] [PubMed] [Google Scholar]
  12. Mauer S. M., Steffes M. W., Ellis E. N., Sutherland D. E., Brown D. M., Goetz F. C. Structural-functional relationships in diabetic nephropathy. J Clin Invest. 1984 Oct;74(4):1143–1155. doi: 10.1172/JCI111523. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mijovic C., Fletcher J. A., Bradwell A. R., Barnett A. H. Phenotypes of the heavy chains of immunoglobulins in patients with diabetic microangiopathy: evidence for an immunogenetic predisposition. Br Med J (Clin Res Ed) 1986 Feb 15;292(6518):433–435. doi: 10.1136/bmj.292.6518.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mogensen C. E., Christensen C. K. Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med. 1984 Jul 12;311(2):89–93. doi: 10.1056/NEJM198407123110204. [DOI] [PubMed] [Google Scholar]
  15. Parving H. H., Smidt U. M., Friisberg B., Bonnevie-Nielsen V., Andersen A. R. A prospective study of glomerular filtration rate and arterial blood pressure in insulin-dependent diabetics with diabetic nephropathy. Diabetologia. 1981 Apr;20(4):457–461. doi: 10.1007/BF00253407. [DOI] [PubMed] [Google Scholar]
  16. Pirart J. Diabète et complications dégénératives présentation d'une étude prospective portant sur 4400 cas observés entre 1947 et 1973. (Première partie). Diabete Metab. 1977 Jun;3(2):97–107. [PubMed] [Google Scholar]
  17. Rewers M., LaPorte R. E., Walczak M., Dmochowski K., Bogaczynska E. Apparent epidemic of insulin-dependent diabetes mellitus in Midwestern Poland. Diabetes. 1987 Jan;36(1):106–113. doi: 10.2337/diab.36.1.106. [DOI] [PubMed] [Google Scholar]
  18. Savage C. O., Pusey C. D., Bowman C., Rees A. J., Lockwood C. M. Antiglomerular basement membrane antibody mediated disease in the British Isles 1980-4. Br Med J (Clin Res Ed) 1986 Feb 1;292(6516):301–304. doi: 10.1136/bmj.292.6516.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Speers M. A., Kasl S. V., Freeman D. H., Jr, Ostfeld A. M. Blood pressure concordance between spouses. Am J Epidemiol. 1986 May;123(5):818–829. doi: 10.1093/oxfordjournals.aje.a114311. [DOI] [PubMed] [Google Scholar]
  20. Thomsen O. F., Andersen A. R., Christiansen J. S., Deckert T. Renal changes in long-term type 1 (insulin-dependent) diabetic patients with and without clinical nephropathy: a light microscopic, morphometric study of autopsy material. Diabetologia. 1984 May;26(5):361–365. doi: 10.1007/BF00266037. [DOI] [PubMed] [Google Scholar]
  21. Viberti G. C., Hill R. D., Jarrett R. J., Argyropoulos A., Mahmud U., Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet. 1982 Jun 26;1(8287):1430–1432. doi: 10.1016/s0140-6736(82)92450-3. [DOI] [PubMed] [Google Scholar]
  22. Wiseman M., Viberti G., Mackintosh D., Jarrett R. J., Keen H. Glycaemia, arterial pressure and micro-albuminuria in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1984 Jun;26(6):401–405. doi: 10.1007/BF00262209. [DOI] [PubMed] [Google Scholar]

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