PARENTAL HYPERTENSION AND PROTEINURIA IN PIMA-INDIANS WITH NIDDM

To determine if parental hypertension is associated with proteinuria i n offspring with non-insulin-dependent diabetes mellitus (NIDDM), 438 diabetic Pima Indians (172 men, 266 women) aged 20 years or more and b oth of their parents were examined. Hypertension was defined as a syst olic blood pressure 140 mm Hg or more, diastolic blood pressure 90 mm Hg or more, or treatment with antihypertensive medicine. Sixty-three p ercent of the fathers and 80 % of the mothers had diabetes at the time their blood pressure was measured. Families in which either parent ha d proteinuria, defined as a urine protein-to-creatinine ratio greater than or equal to 0.5 g/g were excluded; 73 (16.7 %) of the offspring h ad proteinuria. The prevalence rates of proteinuria in the offspring w ere similar if neither parent or only one parent had hypertension (8.9 and 9.4%, respectively), but was significantly higher if both parents had hypertension (18.8 %), after adjustment for age, sex, duration of diabetes, and 2-h post-load plasma glucose concentration in the offsp ring and diabetes in the parents by logistic regression. The odds for proteinuria being present in the offspring if both parents had hyperte nsion was 2.2 times (95 % confidence interval, 1.2 to 4.2) that if onl y one parent had hypertension. When mean arterial pressure and blood p ressure treatment in the offspring were added to the model the relatio nship remained (odds ratio = 2.2; 95 % confidence interval, 1.1 to 4.3 ). Hypertension in both parents is associated with the development of proteinuria in offspring with NIDDM. This relationship was present eve n when controlled for the effects of blood pressure and its treatment in the offspring.