FAMILIAL HYPERTENSION AND ALBUMINURIA IN NORMOTENSIVE TYPE-I DIABETIC-PATIENTS

An inherited predisposition to hypertension may increase susceptibilit y to nephropathy in type I diabetes. We evaluated the influence of a f amily history of essential hypertension on albuminuria in normotensive , normoalbuminuric type I diabetic patients. Forty-two diabetics (12.9 +/-2.04 years) were divided into three groups according to tertiles of albumin excretion rate (group 1, 1.27+/-0.35; group 2, 2.43+/-0.49; g roup 3, 6.37+/-3.43 mu g/min; P<.001). Familial hypertension was consi dered to be present if the patient had one parent or grandparent on an tihypertensive therapy. The three groups did not differ concerning age , diabetes duration, insulin requirement, body mass index, blood press ure, and urinary glucose excretion. Albumin excretion rate did not cor relate with any parameter studied. The frequency of hypertension was s ignificantly lower among the relatives of the patients from group 1 co mpared with those from groups 2 and 3 (28.6% versus 64.3% versus 78.6% , P<.03). Our data suggest that a familial antecedent of hypertension in normoalbuminuric type I diabetic patients is associated with a high normal albumin excretion rate not related to increases in blood press ure. Early changes in renal hemodynamics, seen in patients with a pred isposition to hypertension, may contribute to increments in albuminuri a even within the normal range.