{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T21:17:47Z","timestamp":1776374267903,"version":"3.51.2"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,9,22]]},"abstract":"\n Background<\/jats:title>\n \n Apparent treatment resistant hypertension (\n aTRH<\/jats:styled-content>\n ) is highly prevalent in patients with type 2 diabetes mellitus (T2D) and entails worse cardiovascular prognosis. The impact of\n aTRH<\/jats:styled-content>\n and long\u2010term achievement of recommended blood pressure (\n BP<\/jats:styled-content>\n ) values on renal outcome remains largely unknown. We assessed the role of\n aTRH<\/jats:styled-content>\n and\n BP<\/jats:styled-content>\n on the development of chronic kidney disease in patients with T2D and hypertension in real\u2010life clinical practice.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Clinical records from a total of 29\u00a0923 patients with T2D and hypertension, with normal baseline estimated glomerular filtration rate and regular visits during a 4\u2010year follow\u2010up, were retrieved and analyzed. The association between time\u2010updated\n BP<\/jats:styled-content>\n control (ie, 75% of visits with\n BP<\/jats:styled-content>\n <140\/90\u00a0mm\u00a0Hg) and the occurrence of estimated glomerular filtration rate <60 and\/or a reduction \u226530% from baseline was assessed. At baseline, 17% of patients had\n aTRH<\/jats:styled-content>\n . Over the 4\u2010year follow\u2010up, 19% developed low estimated glomerular filtration rate and 12% an estimated glomerular filtration rate reduction \u226530% from baseline. Patients with\n aTRH<\/jats:styled-content>\n showed an increased risk of developing both renal outcomes (adjusted odds ratio, 1.31 and 1.43;\n P<\/jats:italic>\n <0.001 respectively), as compared with those with non\u2010\n aTRH<\/jats:styled-content>\n . No association was found between\n BP<\/jats:styled-content>\n control and renal outcomes in non\u2010\n aTRH<\/jats:styled-content>\n , whereas in\n aTRH<\/jats:styled-content>\n ,\n BP<\/jats:styled-content>\n control was associated with a 30% (\n P<\/jats:italic>\n =0.036) greater risk of developing the renal end points.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n ATRH<\/jats:styled-content>\n entails a worse renal prognosis in T2D with hypertension.\n BP<\/jats:styled-content>\n control is not associated with a more\u2010favorable renal outcome in\n aTRH<\/jats:styled-content>\n . The relationship between time\u2010updated\n BP<\/jats:styled-content>\n and renal function seems to be J\u2010shaped, with optimal systolic BP values between 120 and 140\u00a0mm\u00a0Hg.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006745","type":"journal-article","created":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T00:12:00Z","timestamp":1506125520000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Resistant Hypertension, Time\u2010Updated Blood Pressure Values and Renal Outcome in Type 2 Diabetes Mellitus"],"prefix":"10.1161","volume":"6","author":[{"given":"Francesca","family":"Viazzi","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino\u2010IST, Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Piscitelli","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Scientific Institute \u201cCasa Sollievo della Sofferenza\u201d, San Giovanni Rotondo (FG), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Ceriello","sequence":"additional","affiliation":[{"name":"Institut d'Investigacions Biom\u00e8diques August Pii Sunyer (IDIBAPS) and Centro de Investigaci\u00f3n Biom\u00e9dicaen Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Barcelona, Spain"},{"name":"Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Fioretto","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Giorda","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Unit, ASL Turin 5, Chieri (TO), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Guida","sequence":"additional","affiliation":[{"name":"Associazione Medici Diabetologi, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"De Cosmo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Scientific Institute \u201cCasa Sollievo della Sofferenza\u201d, San Giovanni Rotondo (FG), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Pontremoli","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino\u2010IST, Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"AMD\u2010Annals Study 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