Tarnow L, Rossing P, Gall M A, Nielsen F S, Parving H H
Steno Diabetes Center, Gentofte, Denmark.
Diabetes Care. 1994 Nov;17(11):1247-51. doi: 10.2337/diacare.17.11.1247.
To compare the prevalence of arterial hypertension in patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) according to blood pressure (BP) criteria from the World Health Organization (WHO) and The Fifth Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V).
Two cohorts of Caucasian patients attending the outpatient clinic at Hvidöre Hospital were identified: 1) 957 patients with IDDM; 53% men, 40 (18-75) years of age (mean [range]); and 2) 549 patients with NIDDM; 53% men, 60 (20-76) years of age. BP was measured at least yearly, while patients rested in a sitting position, with a standard clinical sphygmomanometer. Patients were classified as hyper- or normotensive based on average BP during a 3-year follow-up period. Patients receiving antihypertensive treatment were classified as hypertensives.
In IDDM patients, the prevalence of arterial hypertension rose from 15 to 42% in the normoalbuminuric group, from 26 to 52% in the microalbuminuric group, and from 61 to 79% in the macroalbuminuric group when WHO and JNC-V criteria were compared. The corresponding rises in NIDDM patients were from 51 to 71% (normo-), from 73 to 90% (micro-), and from 82 to 93% (macroalbuminuria). Of the untreated hypertensive patients, 78% of IDDM patients and 50% of NIDDM patients had stage 1 (140-159/90-99 mmHg) hypertension; 20% of IDDM patients and 37% of NIDDM patients had stage 2 (160-179/100-109 mmHg) hypertension. Two out of three untreated hypertensive patients had isolated systolic hypertension.
The new JNC-V criteria approved by the American Diabetes Association leads to a considerable increase in the prevalence of arterial hypertension in a population of IDDM and NIDDM patients. Isolated systolic hypertension contributes importantly.
根据世界卫生组织（WHO）和美国国家联合委员会关于高血压检测、评估与治疗的第五次报告（JNC-V）的血压标准，比较胰岛素依赖型糖尿病（IDDM）患者和非胰岛素依赖型糖尿病（NIDDM）患者中动脉高血压的患病率。
确定了两组在Hvidöre医院门诊就诊的白种人患者：1）957例IDDM患者，男性占53%，年龄40（18 - 75）岁（平均[范围]）；2）549例NIDDM患者，男性占53%，年龄60（20 - 76）岁。使用标准临床血压计，患者至少每年测量一次坐位休息时的血压。根据3年随访期内的平均血压将患者分为高血压或血压正常。接受抗高血压治疗的患者被归类为高血压患者。
在IDDM患者中，当比较WHO和JNC-V标准时，正常白蛋白尿组动脉高血压患病率从15%升至42%，微量白蛋白尿组从26%升至52%，大量白蛋白尿组从61%升至79%。NIDDM患者相应的升高分别为正常白蛋白尿组从51%升至71%，微量白蛋白尿组从73%升至90%，大量白蛋白尿组从82%升至93%。在未治疗的高血压患者中，78%的IDDM患者和50%的NIDDM患者患有1期（140 - 159/90 - 99 mmHg）高血压；20%的IDDM患者和37%的NIDDM患者患有2期（160 - 179/100 - 109 mmHg）高血压。三分之二未治疗的高血压患者患有单纯收缩期高血压。
美国糖尿病协会批准的新JNC-V标准导致IDDM和NIDDM患者群体中动脉高血压患病率显著增加。单纯收缩期高血压起重要作用。
