Key result
Among 23 prehypertensive adults with type 1 diabetes, non-dippers (n=12) had higher left ventricular mass index and left atrial dimensions compared with dippers (n=11).
Why the study?
Does a non-dipper blood pressure pattern correlate with adverse echocardiographic parameters compared to a dipper pattern in normoalbuminuric pre-hypertensive adults with T1DM?
Cross-Sectional (n=23)
Does a non-dipper blood pressure pattern correlate with adverse echocardiographic parameters compared to a dipper pattern in normoalbuminuric pre-hypertensive adults with T1DM?
In prehypertensive T1DM patients, a nondipper blood pressure pattern is associated with higher LV mass index and left atrial dimensions, which may presage worse long-term cardiovascular outcomes.
Non-dipper pattern may signal higher cardiac risk in prehypertensive T1DM; leaves open need for prospective outcome studies.
Aim: To investigate the relation between echocardiographic parameters and 24-hour ambulatory blood pressure monitoring (ABPM) in normoalbuminuric pre-hypertensive adults with type 1 diabetes mellitus (T1DM) without clinical evidence of nephropathy or cardiovascular autonomic neuropathy. Methods: Adult patients who were diagnosed as T1DM and pre-hypertensive were categorized as dippers and non-dippers on the basis of 24-hour ambulatory blood pressure measurement and their echocardiographic parameters were compared. An oscillometric portable monitor took twenty-four hour blood pressure measurements automatically. A comprehensive echocardiographic evaluation was performed focusing on the left ventricular (LV) dimensions, LV mass index, relative wall thickness (RWT), left trial (LA) dimension and LV ejection fraction. Results: Of the 23 T1DM pre-hypertensive patients, 11 were categorized as dippers and 12 as nondippers. There were no differences between the dipper and the nondipper T1DM pre-hypertensive patients with respect to age, gender, body mass index, clinical and ABPM for average day-time systolic and diastolic blood pressure levels. Left ventricular (LV) internal diameters, LV septal and posterior wall thicknesses, LV ejection fraction (LVEF) were all similar in both groups. Left atrial diameter and LV mass index were found higher in the nondipper T1DM patients. There was no significant difference between two groups in terms of RWT although there was a trend for it to be higher in the nondipper group. Conclusion: Among prehypertensive T1DM patients evaluated by ambulatory BP monitoring, nondippers had higher LV mass index and left atrial dimensions compared with dippers. This may presage worse long term cardiovascular outcomes in nondippers.
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A 2006 study conducted a cross-sectional in Normoalbuminuric pre-hypertensive type 1 diabetes mellitus (n=23). Non-dipper blood pressure pattern vs. Dipper blood pressure pattern was evaluated on Echocardiographic parameters (LV mass index, left atrial dimension, LV dimensions, RWT, LVEF). Among 23 prehypertensive adults with type 1 diabetes, non-dippers (n=12) had higher left ventricular mass index and left atrial dimensions compared with dippers (n=11).
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