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February 1, 1993Journal of Internal Medicine

Day and night variation in ambulatory blood pressure in type 1 diabetes mellitus with nephropathy and autonomic neuropathy

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Why the study?

How does day and night variation in ambulatory blood pressure and heart rate differ in type 1 diabetic patients with nephropathy compared to those without nephropathy and healthy controls?

Population

38 subjects total: 20 type 1 diabetic patients with diabetic nephropathy on antihypertensive treatment, 8…

Design

Cross-sectional

Authors

OTOle TorffvitLund UniversityCAC.‐D. AGARDHLund University

Discussion

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Implication

Blunted diurnal BP and HR variation may signal autonomic neuropathy in T1DM nephropathy; leaves open prognostic value and need for prospective studies.

Key Points

  • To assess day-to-night ambulatory blood pressure and heart rate variability in type 1 diabetes mellitus patients across stages of nephropathy and evaluate the role of autonomic neuropathy.
  • Monitored 24-hour ambulatory blood pressure using an oscillometric device in 20 type 1 diabetic patients with nephropathy on antihypertensive therapy.
  • Compared findings against 8 insulin-treated patients with short diabetes duration (1–5 years) and 10 healthy control subjects.
  • Assessed autonomic neuropathy by measuring RR-interval variation during deep breathing and standing tests.
  • 24-hour blood pressure was higher overall in patients with diabetic nephropathy than in uncomplicated diabetic patients and healthy controls.
  • Patients with nephropathy demonstrated a significantly lower day-to-night diastolic blood pressure ratio compared to controls (1.15 ± 0.12 vs. 1.25 ± 0.76, P < 0.05).
  • Day-to-night heart rate ratio was significantly blunted in nephropathy patients (1.15 ± 0.08) compared to uncomplicated diabetic patients (1.26 ± 0.09) and controls (1.27 ± 0.08, P < 0.01), with all nephropathy patients showing autonomic neuropathy.

Structured PICO

How does day and night variation in ambulatory blood pressure and heart rate differ in type 1 diabetic patients with nephropathy compared to those without nephropathy and healthy controls?

P
Population
38 subjects total: 20 type 1 diabetic patients with diabetic nephropathy on antihypertensive treatment, 8 insulin-treated diabetic patients with short duration of diabetes (1-5 years), and 10 apparently healthy subjects.
C
Comparator
Diabetic patients without nephropathy and healthy control subjects
O
Outcome
Day and night variation in ambulatory blood pressure and heart rate variabilitysurrogate

Type 1 diabetic patients with nephropathy and autonomic neuropathy exhibit blunted day-night variations in diastolic blood pressure and heart rate.

Cite This Study

Torffvit et al. (1993) studied this question.

synapsesocial.com/papers/6a836aea954bb9d4ab71d6echttps://doi.org/10.1111/j.1365-2796.1993.tb00665.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Twenty‐four Hour Blood Pressure and Heart Rate Profiles of Diabetic Patients with Abnormal Cardiovascular Reflexes1991 · 36 citations
  2. 2Recognition of Hypertension and Abnormal Blood Pressure Burden With Ambulatory Blood Pressure Recordings in Type I Diabetes Mellitus1990 · 63 citations
  3. 3Ambulatory blood pressure monitoring in diabetic males: A method for detecting blood pressure elevations undisclosed by conventional methods1982 · 24 citations
  4. 4Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy1982 · 763 citations
  5. 5Is Exercise‐induced Blood Pressure Rise Predictive of Nephropathy in Insulin‐dependent Diabetes?1987 · 4 citations