de Pablos-Velasco P L, Martínez-Martín F J, Aguilar J A
Department of Endocrinology, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain.
Diabetes Res Clin Pract. 1997 Dec;38(3):191-7. doi: 10.1016/s0168-8227(97)00097-1.
In order to establish the prevalence of hypertension (according to both the JNC-V/ADA and the WHO/ISH criteria) in patients with insulin-dependent diabetes mellitus (IDDM), a group of 142 unselected young adults with IDDM from Northern Gran Canaria Island was cross-sectionally studied. The relationship of hypertension to diabetic nephropathy and lipid profile was also studied. Blood pressure, urinary albumin excretion and plasma lipids (total cholesterol with VLDL, LDL and HDL fractions, triglycerides and Lp(a)) were measured. The prevalence of hypertension was 11.9% (95% CI 6.5-17.3) with the WHO criteria (> 160/95 mmHg) versus 58.7% (50.5-66.9) with the JNC-V criteria (> 130/85 mmHg). The respective prevalences were 3.8 (0.0-8.1) versus 49.4% (38.0-60.7) in patients with normoalbuminuria (< or = 20 micrograms/min), 17.9 (2.7-33.0) versus 71.4% (53.6-89.3) in patients with microalbuminuria (21-200 micrograms/min), and 44.4 (9.0-69.9) versus 83.3% (64.3-100) in patients with macroalbuminuria (> 200 micrograms/min). The presence of hypertension and of micro or macroalbuminuria was associated with a worse lipid profile.
the new JNC-V criteria drastically increase the figures of prevalence of hypertension in young insulin-dependent diabetic adults. Early and aggressive antihypertensive treatment benefits at least those patients with incipient nephropathy.
为确定胰岛素依赖型糖尿病（IDDM）患者中高血压的患病率（根据美国国家联合委员会第五版/美国糖尿病协会和世界卫生组织/国际高血压学会标准），对来自大加那利岛北部的142例未经挑选的IDDM年轻成年人进行了横断面研究。还研究了高血压与糖尿病肾病和血脂谱的关系。测量了血压、尿白蛋白排泄量和血浆脂质（总胆固醇以及极低密度脂蛋白、低密度脂蛋白和高密度脂蛋白组分、甘油三酯和脂蛋白(a)）。根据世界卫生组织标准（收缩压>160mmHg和舒张压>95mmHg），高血压患病率为11.9%（95%可信区间6.5 - 17.3）；而根据美国国家联合委员会第五版标准（收缩压>130mmHg和舒张压>85mmHg），患病率为58.7%（50.5 - 66.9）。在尿白蛋白排泄正常（≤20微克/分钟）的患者中，相应患病率分别为3.8%（0.0 - 8.1）和49.4%（38.0 - 60.7）；在微量白蛋白尿（21 - 200微克/分钟）患者中，分别为17.9%（2.7 - 33.0）和71.4%（53.6 - 89.3）；在大量白蛋白尿（>200微克/分钟）患者中，分别为44.4%（9.0 - 69.9）和83.3%（64.3 - 100）。高血压以及微量或大量白蛋白尿的存在与较差的血脂谱相关。
美国国家联合委员会第五版新的高血压标准大幅提高了年轻胰岛素依赖型糖尿病成年人中高血压的患病率。早期积极的抗高血压治疗至少对那些早期肾病患者有益。
