PREDISPOSITION TO ESSENTIAL-HYPERTENSION AND DEVELOPMENT OF DIABETIC NEPHROPATHY IN IDDM PATIENTS

Conflicting results have been reported on the relationship between fam ilial predisposition to hypertension and development of diabetic nephr opathy in IDDM, In our case-control study, we assessed the prevalence of hypertension among parents of 73 IDDM patients with diabetic nephro pathy (DN+; persistent albuminuria > 200 mu g/min or > 300 mg/24 h) an d 73 IDDM patients without diabetic nephropathy (DN-; urinary albumin excretion < 20 mu g/min or < 30 mg/24 h), Arterial hypertension, defin ed as antihypertensive therapy or a 24-h ambulatory blood pressure (Sp aceLabs 90207) greater than or equal to 135/85 mmHg, was present in 57 % of parents of DN+ patients compared with 41% of parents of DN- patie nts (P = 0.034; difference 16% [95% CI 1.3-29.6%]), In addition, the c umulative incidence of hypertension was higher among parents of DN+ pa tients (log-rank test P < 0.001), with a shift toward younger age at o nset of hypertension in this group, However, the difference in prevale nce of parental hypertension was not evident using office blood pressu re measurements (64 vs, 57%; NS; difference 7% [-5.8-20%]). Furthermor e: patients with DN+ and with antihypertensive therapy in both parents were themselves more frequently treated for hypertension than were pa tients with DN+ and without parental treatment for hypertension (100 v s, 61%; P = 0.034; difference 39% [21-57%]), In conclusion, familial p redisposition to essential hypertension increases the risk of diabetic nephropathy and may also contribute to the development of systemic hy pertension in patients with IDDM and diabetic nephropathy,