Document Detail


Cardiac autonomic neuropathy, estimated cardiovascular risk, and circadian blood pressure pattern in diabetes mellitus.
MedLine Citation:
PMID:  19637052     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was designed to investigate potential factors involved in the disruption of the circadian blood pressure (BP) pattern in diabetes mellitus, as well as the relation between BP, cardiac autonomic neuropathy, and estimated cardiovascular risk. We studied 101 diabetic patients (58% with type 2 diabetes; 59% men), age 21-65 yrs, evaluated by 48 h BP monitoring. We performed three autonomic tests in a single session: deep breathing, Valsalva maneuver, and standing up from a seated position. Patients were classified according to the number of abnormal tests and their 10 yr risk of coronary heart disease or stroke. The prevalence of non-dipping 24 h patterning ranged from 47.6% in type 1 to 42.4% in type 2 diabetes. The awake/asleep ratio of systolic BP (SBP) was comparable between patients with or without abnormal autonomic tests. Pulse pressure (PP) was significantly higher in patients with > or =1 abnormal autonomic test (p < 0.001). Ambulatory SBP was significantly elevated in the group with higher risk of coronary heart disease (p < 0.001). Patients with higher stroke-risk had higher SBP but lower diastolic BP, and thus an elevated ambulatory PP by 9 mmHg, compared to those with lower risk (p < 0.001). Cardiac autonomic neuropathy is not the main causal-factor for the non-dipper BP pattern in diabetes mellitus. The most significant finding from this study is the high ambulatory PP found in patients with either cardiac autonomic dysfunction or high risk for coronary heart disease or stroke. After correcting for age, this elevated PP level emerged as the main cardiovascular risk factor in diabetes mellitus.
Authors:
Jose Cabezas-Cerrato; Ramon Carmelo Hermida; Jose Manuel Cabezas-Agricola; Diana Elva Ayala
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chronobiology international     Volume:  26     ISSN:  1525-6073     ISO Abbreviation:  Chronobiol. Int.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501362     Medline TA:  Chronobiol Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  942-57     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain. jose.cabezas@usc.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Autonomic Nervous System Diseases / pathology
Blood Pressure
Blood Pressure Monitoring, Ambulatory / methods
Cardiovascular Diseases / diagnosis,  pathology
Cardiovascular System / physiopathology*
Circadian Rhythm
Diabetes Mellitus / pathology*,  therapy
Female
Humans
Male
Middle Aged
Models, Biological
Risk
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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