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Diurnal blood pressure variations in normoalbuminuric type 1 diabetic patients.

Abstract：

OBJECTIVE:To test the hypothesis that normoalbuminuric type 1 diabetic patients segregate into groups with normal and elevated ambulatory blood pressure. To evaluate diurnal variation of blood pressure assessed by individual or fixed night-time periods. DESIGN:Cross-sectional study. SETTING:Tertiary referral centre. SUBJECTS:Inclusion criteria for type 1 diabetic patients (n = 33): normal urinary albumin excretion (UAE age < 45 < 20 micrograms min-1), diabetes duration < or = 20 years, age 45 years. Healthy controls (n = 33) were matched for sex and age. MAIN OUTCOME MEASURE:Twenty-four hour, day-time, night-time and night/day ratio of ambulatory blood pressure. RESULTS:Twenty-four-hour blood pressure in diabetic patients did not differ significantly from a normal distribution. The 24-h systolic blood pressure was higher in diabetic patients than in healthy controls (difference: 6 mmHg, 95% confidence interval (CI) from 1 to 10 mmHg, P < 0.05), while no significant differences were found for diastolic values. The 24-h systolic blood pressure in diabetic patients with UAE above the median value (5.8 micrograms min-1) was higher than for those with lower UAE (difference: 7 mmHg, 95% CI from 0.5 to 13 mmHg, P < 0.05). The night/day ratio of diastolic blood pressure based on individual informations of the night period was (mean +/- SD) 80 +/- 6% in diabetic patients and 78 +/- 8% in controls (difference: 2%, 95% CI from -1 to 5%, not significant [NS]). This ratio increase significantly (P < 0.00001) to 90 +/- 5% in diabetes and to 84 +/- 7% in controls if a fixed night period from 22.30 hours to 06.30 hours was assumed. CONCLUSIONS:It was not possible to identify a well-separated group of normoalbuminuric type 1 diabetic patients with elevated ambulatory blood pressure. Values of UAE above the median in diabetic patients are associated with higher ambulatory blood pressure. Assessment of the night/day variation from fixed time-points should be abandoned because this leads to a serious underestimation of the nocturnal reduction in blood pressure.

journal_name

J Intern Med

journal_title

Journal of internal medicine

authors

Hansen KW,Pedersen MM,Christiansen JS,Mogensen CE

doi

10.1111/j.1365-2796.1993.tb00727.x

subject

Has Abstract

pub_date

1993-08-01 00:00:00

pages

175-80

issue

eissn

0954-6820

issn

1365-2796

journal_volume

234

pub_type

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Diurnal blood pressure variations in normoalbuminuric type 1 diabetic patients.