What question did this study set out to answer?

To investigate the impairment of nocturnal blood pressure reduction and its underlying physiological mechanisms in diabetic patients with autonomic neuropathy.

January 1, 1992Japanese Heart JournalOpen Access

Loss of Nocturnal Decline in Blood Pressure in Diabetic Patients with Autonomic Neuropathy.

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Why the study?

Does autonomic neuropathy affect the nocturnal decline in blood pressure in diabetic patients?

Population

52 hospitalized subjects with diabetes mellitus and 13 normal volunteers as controls.

Design

Cross-sectional

Follow-up

24 hours

Authors

YUYasuo UedaNishinomiya Municipal Central Hospital WAWataru AoiKyoto Prefectural University SYShiro YamachikaInoue Hospital

Discussion

Member takes

Implication

Impaired nocturnal BP dipping was associated with autonomic neuropathy in diabetes; leaves open whether targeted interventions improve outcomes.

Key Points

To investigate the impairment of nocturnal blood pressure reduction and its underlying physiological mechanisms in diabetic patients with autonomic neuropathy.
Monitored ambulatory blood pressure every 30 minutes in 52 diabetic patients and 11 nondiabetic controls to assess the difference between daytime (09:00–13:00) and nighttime (01:00–05:00) mean blood pressure.
Assessed autonomic nervous function using the coefficient of variation of the ECG R-R interval (CVRR) and orthostatic diastolic blood pressure changes, alongside measuring plasma volume via RISA.
Nondiabetic controls demonstrated a significant nighttime mean blood pressure reduction of -12.8 ± 7.5 mmHg, compared to only -3.3 ± 8.6 mmHg in diabetic patients (p < 0.001).
Diabetic patients exhibiting a loss of nocturnal blood pressure decline presented with measurable autonomic nervous dysfunction and increased plasma volume.

Structured PICO

Does autonomic neuropathy affect the nocturnal decline in blood pressure in diabetic patients?

Population

52 hospitalized subjects with diabetes mellitus (27 men, 25 women, mean age 52) and 13 normal volunteers (1 man, 12 women, mean age 56.9) as controls.

Comparator

Normal controls and diabetic patients with normal nocturnal blood pressure decline.

Outcome

Difference between daytime mean blood pressure (09:00 to 13:00) and nighttime mean blood pressure (01:00 to 05:00).surrogate

Diabetic patients with autonomic neuropathy exhibit a loss of nocturnal blood pressure decline, likely due to an imbalance in autonomic tone and increased plasma volume.

Limitations

Multivariate analysis was not performed because of the relatively small number of patients.

Cite This Study

Ueda et al. (1992) studied this question.

synapsesocial.com/papers/6a73a3127af34f94aaa73517 https://doi.org/10.1536/ihj.33.801

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Implication

Impaired nocturnal BP dipping was associated with autonomic neuropathy in diabetes; leaves open whether targeted interventions improve outcomes.

Loss of Nocturnal Decline in Blood Pressure in Diabetic Patients with Autonomic Neuropathy.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Loss of Nocturnal Decline in Blood Pressure in Diabetic Patients with Autonomic Neuropathy.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider