Key result
Reverse dipping in diabetes is linked to ~120% higher all-cause mortality risk versus dippers.
Why the study?
The long-term prognostic value of abnormal circadian blood pressure patterns in diabetes remained to be established.
Do abnormal circadian blood pressure patterns (nondipping and reverse-dipping) increase the risk of long-term mortality in patients with diabetes?
Population
349 outpatients with diabetes screened for microvascular complications
Comparison
Dipping vs nondipping vs reverse-dipping circadian BP patterns on ABPM
Design
Retrospective cohort study
Follow-up
Median 21.0 years
Authors
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Supports ambulatory BP monitoring for risk stratification in diabetes; leaves open whether nocturnal BP targeting reduces mortality.
Cohort (n=349)
Do abnormal circadian blood pressure patterns (nondipping and reverse-dipping) increase the risk of long-term mortality in patients with diabetes?
Effect estimate: HR 2.2 (95% CI 1.3-3.8)
In patients with diabetes, a reverse-dipping blood pressure pattern on 24-hour ambulatory monitoring is associated with a doubled risk of all-cause mortality over a 21-year follow-up.
Chiriacò et al. (2022) conducted a cohort in diabetes (n=349). Reverse-dipping blood pressure pattern vs. Dipping blood pressure pattern was evaluated on all-cause mortality (HR 2.2, 95% CI 1.3-3.8). Reverse dipping in patients with diabetes was associated with a twofold increased risk of all-cause mortality compared with dippers over a 21-year follow-up (HR 2.2; 95% CI 1.3-3.8).
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