Document Detail

Blood pressure means rather than nocturnal dipping pattern are related to complications in Type 2 diabetic patients.
MedLine Citation:
PMID:  18201207     Owner:  NLM     Status:  MEDLINE    
AIM: To determine whether systolic and diastolic blood pressure (BP) means, during ambulatory BP monitoring (ABPM), are more strongly correlated with microvascular complications and echocardiographic structural alterations than night-time/daytime (N/D) BP ratio. METHODS: A cross-sectional study was conducted in 270 Type 2 diabetes mellitus (DM) outpatients who underwent clinical and laboratory investigations, urinary albumin excretion rate (UAER) determination, echocardiography, office and 24-h ABPM (Spacelabs 90207). RESULTS: UAER, after multivariate adjustments, was associated with office BP (systolic: R(2)(a) 0.162, P < 0.001; diastolic: R(2)(a) 0.124, P < 0.001) and ABPM (24-h systolic: R(2)(a) 0.195, P < 0.001; 24-h diastolic: R(2)(a) 0.197, P < 0.001) but not with N/D BP ratios (systolic: R(2)(a) 0.062, P = 0.080; diastolic: R(2)(a) 0.063, P = 0.069). Similar results were observed for echocardiographic parameters. The presence of retinopathy was associated only with night-time BP values [systolic means: odds ratio (OR) 1.13, 95% confidence interval (CI) 1.03-1.24 and diastolic means: OR 1.21, CI 1.04-1.40 and N/D diastolic BP ratio > 0.90, OR 3.21, CI 1.65-6.25]. CONCLUSIONS: UAER and echocardiographic structural alterations had more consistent correlations of a greater magnitude with systolic BP means than with N/D BP ratios. The nocturnal BP values appear to be more relevant for diabetic retinopathy. BP measurement in patients with Type 2 DM should take into account the 24-h period rather than focusing on a specific time span of BP homeostasis.
C B Leitão; L H Canani; C K Kramer; M Moehlecke; L C Pinto; E D Ricardo; A F Pinotti; J L Gross
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-14
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  25     ISSN:  1464-5491     ISO Abbreviation:  Diabet. Med.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  308-13     Citation Subset:  IM    
Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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MeSH Terms
Albuminuria / metabolism*
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology
Diabetes Mellitus, Type 2 / physiopathology*
Diabetic Angiopathies / physiopathology*
Diabetic Nephropathies / physiopathology*
Diabetic Retinopathy / physiopathology*
Hypertension / physiopathology
Middle Aged

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