Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan.
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
J Clin Hypertens (Greenwich). 2020 Dec;22(12):2306-2314. doi: 10.1111/jch.14084. Epub 2020 Oct 21.
The decrease in blood pressure is thought to play an important role for the renoprotective effects of sodium-glucose cotransporter 2 inhibitors in patients with diabetes mellitus. However, their influence on blood pressure at home has not been well studied. The aim of this study is to clarify how long-term use of sodium-glucose cotransporter 2 inhibitors influence on blood pressure both at the office and at home, and the kidney function. We retrospectively analyzed 102 patients with type 2 diabetes mellitus and chronic kidney disease to whom sodium-glucose cotransporter 2 inhibitors were administered for more than 1 year, and whose blood pressure were monitored both at the office and at home. The blood pressure at the office and at home significantly decreased, and there was a significant positive correlation between both blood pressure values. Controlled, white-coat, and sustained hypertension were observed in 9.8%, 14.7%, and 55.9% of the patients at the beginning of the treatment, which changed to 16.7%, 15.7%, and 48.0% at the time of the survey, however, the ratio of masked hypertension was not changed (19.6%). The cutoff value of mean arterial pressure at home after treatment for the improvement of urine albumin to creatinine ratio was 92.0 mm Hg, with 54.1% of sensitivity and 60.0% of specificity. Sodium-glucose cotransporter 2 inhibitors can be useful for the strict management of blood pressures both at the office and at home. The decrease in blood pressure at home by this treatment might be related to the improvement of diabetic nephropathy.
血压降低被认为在糖尿病患者的钠-葡萄糖共转运蛋白 2 抑制剂的肾脏保护作用中发挥重要作用。然而，它们对家庭血压的影响尚未得到很好的研究。本研究旨在阐明长期使用钠-葡萄糖共转运蛋白 2 抑制剂对办公室和家庭血压以及肾功能的影响。我们回顾性分析了 102 例患有 2 型糖尿病和慢性肾脏病且接受钠-葡萄糖共转运蛋白 2 抑制剂治疗超过 1 年的患者，这些患者的血压在办公室和家庭都进行了监测。办公室和家庭的血压均显著降低，且两者之间存在显著的正相关关系。治疗开始时，患者中存在 9.8%的控制型、白大衣型和持续性高血压，14.7%的白大衣型高血压和 55.9%的持续性高血压，而在调查时，分别变为 16.7%、15.7%和 48.0%，但隐匿性高血压的比例没有变化（19.6%）。治疗后尿白蛋白与肌酐比值改善时，家庭平均动脉压的截断值为 92.0mmHg，其敏感性为 54.1%，特异性为 60.0%。钠-葡萄糖共转运蛋白 2 抑制剂可用于严格管理办公室和家庭的血压。这种治疗方法使家庭血压降低可能与糖尿病肾病的改善有关。
