Between March 1993 and August 1998, 111 patients with
type 1 diabetes mellitus underwent successful
pancreas transplantation (108 kidney/
pancreas transplantation) and another 28 patients with
type 1 diabetes mellitus underwent isolated
kidney transplantation. Blood pressure measurements and all
antihypertensive medications were determined for both groups before
transplantation and at 1, 3, 6, and 12 months and at the most recent outpatient evaluation after
transplantation. At baseline, the mean blood pressure was 151/88 and 151/83 mm Hg for the kidney/pancreas and isolated kidney transplant patients, respectively. The mean blood pressure decreased to 134/77 mm Hg 1 month after kidney/
pancreas transplantation (P<0.001) and decreased further to 126/70 mm Hg (P<0.001) at a mean follow-up of 18 months. This reduction in blood pressure after
transplantation occurred despite a decrease in
antihypertensive medications and the institution of
immunosuppressive agents. At 1 month after kidney/
pancreas transplantation, the average number of
antihypertensive medications per patient was 0.9+/-1.0, compared with 2.5+/-1.1 before surgery (P<0.001). At 18 months after
transplantation, 34% of patients were both normotensive (blood pressure </=130/85 mm Hg) and receiving no
antihypertensive medications. In contrast, there was no significant decrease in systolic blood pressure or
antihypertensive medication use in the patients receiving an isolated kidney transplant.
CONCLUSIONS: