PREDIABETIC BLOOD-PRESSURE PREDICTS URINARY ALBUMIN EXCRETION AFTER THE ONSET OF TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS IN PIMA-INDIANS

Blood pressure was measured in 490 non-proteinuric Pima Indians from t he Gila River Indian Community in Arizona at least 1 year before the d iagnosis of Type 2 (non-insulin-dependent) diabetes mellitus. Urine al bumin concentration was measured in the same subjects 0-24 years (mean 5 years) after diabetes was diagnosed. Prevalence rates of abnormal a lbumin excretion (albumin-to-creatinine ratio greater-than-or-equal-to 100 mg/g) after the onset of Type 2 diabetes were 9 %, 16 %, and 23 % , respectively, for the lowest to highest tertiles of pre-diabetic mea n blood pressure. When controlled for age, sex, duration of diabetes a nd pre-diabetic 2-h post-load plasma glucose concentration, higher pre -diabetic mean blood pressure predicted abnormal urinary excretion of albumin after the onset of diabetes. This finding suggests that the hi gher blood pressure seen in diabetic nephropathy is not entirely a res ult of the renal disease, but may precede and contribute to it.