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Aim: It was demonstrated that home blood pressure (HBP) has a stronger predictive power for death, microand macrovascular complications than clinic blood pressure (CBP) in patients with type 2 diabetes mellitus (T2DM). This study investigated which of these measurements offers predicatively stronger power for outcomes over 10 years in non-obese and obese patients with T2DM. Methods: At baseline and end-point, 400 Japanese patients with T2DM were classified as having non-obesity or obesity with hypertension or normotension. Body mass index with < 25.0 kg/m2 and ≧25.0 kg/m2, and same thresholds of systolic blood pressure with ≥ 130 mmHg and < 130 mmHg are defined as non-obesity and obesity, and hypertensions and normotensions, respectively. Mean survey duration was 95 months. Primary and secondary outcomes were death, and new or worsened microand macrovascular events, respectively. Differences in outcomes for end-point were analyzed using Kaplan-Meier survival curves and log-rank testing. Associated risk factors were assessed using Cox proportional hazards analysis. Results: Based on HBP, incidences in death, and micro-and macrovascular events were significantly higher in obesity than in non-obesity. However, based on CBP, there were no significant differences of incidences in their vascular events between obesity and non-obesity. One risk-factor associated with obese patients with elevated HBP was therapy for hypertension. Conclusion: this 10-yearsstudy of patients with T2DM demonstrated that elevated HBP is more predictive death and microand macrovascular complications in obesity than in non-obesity. Abbreviations: BP: Blood pressure, BMI: Body mass index, CBP: Clinic blood pressure, CI: Confidence intervals, CHD: Coronary heart diseases, CVD: Cerebrovascular diseases, DBP: Diastolic blood pressure, HbA1c: Glycated hemoglobin A1c, HBP: Home blood pressure, HDL: High density lipoprotein, HT: Hypertension, LDL: Low density lipoprotein, NGSP: National gycohemoglobin standardization program, NT: Normotension, PAO: Peripheral artery obstruction, SBP: Systolic blood pressure, T2DM: Type 2 diabetes mellitus, TC: Total cholesterol, TG: Triglyceride, UAER: Urinary albumin excretion rate death and microand macrovascular complications in patients with type 2 diabetes mellitus (T2DM) than casual/clinic blood pressure (CBP) measured [1-3]. Since early time, it is known that obesity in patients with T2DM has a risk-factor for hypertension (HT) measured on CBP [4-6], which influences vascular complications. The study examined whether CBP or HBP measurements provided stronger predictive power for outcomes by comparing cumulative events between non-obese and obese patients with T2DM with either HT or normotension (NT) over 10 years. Materials and Methods

journal of hypertension and management

Usefulness of Morning Home Blood Pressure Measurements in Non-Obese and Obese Japanese Patients with Type 2 Diabetes Mellitus: Results of a 10-Years, Prospective and Longitudinal Study