The nondipping blood pressure pattern in type 1 diabetes mellitus is associated with poor cardiac autonomic function, early diabetic kidney disease, and a two-fold increase in all-cause mortality.
The nondipping blood pressure pattern in T1DM significantly increases cardiovascular and mortality risk, yet lacks consensus on specific treatment recommendations, highlighting a gap for future research.
BACKGROUND: The nondipping blood pressure (BP) pattern, characterized by a less than 10% decline in sleep-time BP compared to awake-time values, is prevalent in individuals with type 1 diabetes mellitus (T1DM) and is associated with increased cardiovascular (CV) risk. CASE REPORT: This review discusses the prevalence, pathophysiological mechanisms, complications, and management strategies of the nondipping pattern in T1DM. The nondipping pattern is linked to poor cardiac autonomic function, higher rates of albuminuria, early markers of diabetic kidney disease, and increased arterial stiffness. It is also associated with a two-fold increase in all-cause mortality. DISCUSSION: Despite its clinical significance, there is no consensus on specific treatment recommendations for nondippers with T1DM. While some studies suggest that bedtime administration of antihypertensive medications, such as ACE inhibitors and angiotensin II receptor blockers, can improve the dipping pattern and reduce CV events, these findings are primarily based on studies in the general hypertensive population. Emerging evidence also indicates a potential role for vitamin D supplementation and lifestyle interventions in improving BP variability. CONCLUSION: Further research is needed to develop evidence-based management strategies tailored to nondippers with T1DM, aiming to reduce CV risk and improve long-term outcomes.
Kulecki et al. (Sat,) conducted a review in Type 1 Diabetes Mellitus. Nondipping blood pressure pattern was evaluated. The nondipping blood pressure pattern in type 1 diabetes mellitus is associated with poor cardiac autonomic function, early diabetic kidney disease, and a two-fold increase in all-cause mortality.
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