Afternoon Blood Pressure Increase: A Blood Pressure Pattern Associated With Microvascular Complications in Type 2 Diabetes Mellitus

Kramer, Caroline; Leitão, Cristiane Bauermann; Canani, Luís Henrique Santos; Gross, Jorge Luiz

doi:10.1038/ajh.2010.202

Cited by 9 publications

(8 citation statements)

References 23 publications

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“…Successive studies in type 1 and type 2 diabetes [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], some of which have been summarised in Tables 1 and 2, respectively, provided consistent evidence that: 1) ABPM was reproducible and useful to detect whitecoat and masked hypertension [24,30,34]. Whether or not white-coat hypertension can worsen cardiovascular prognosis in diabetic people remains controversial [30,[39][40][41];…”

Section: Evidence For Altered Characteristics Of Blood Pressure Rhythmentioning

confidence: 94%

Circadian Rhythm of Blood Pressure in Diabetes Mellitus: Evidence, Mechanisms and Implications

Matteucci

Giampietro²

2012

CDR

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Circadian misalignment has been implicated in the development of diabetes mellitus and cardiovascular disease. Circadian rhythms of blood pressure (BP) and heart rate (HR) have long been known and the mechanisms controlling them have been actively investigated in physiology and disease. In this respect, the introduction of 24-hour ambulatory blood pressure monitoring (ABPM) has enabled a more accurate assessment of circadian BP patterns in order to solve diagnostic uncertainty or to establish dipper status. However, attention has been mainly focused on measures of extent (midline estimating statistic of rhythm, MESOR, and amplitude) rather than timing (acrophase) of changes within a cycle. The review summarises 1) evidence for altered characteristics of BP rhythm (in particular, phase shifts along the time axis) in animal and human diabetes mellitus, 2) the mechanisms that have been supposed to underlie the observed changes in cardiovascular function before diabetes onset and during progression of the disease, and 3) the adverse consequences that may result from an altered circadian BP rhythm.

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Section: Evidence For Altered Characteristics Of Blood Pressure Rhythmentioning

confidence: 94%

Circadian Rhythm of Blood Pressure in Diabetes Mellitus: Evidence, Mechanisms and Implications

Matteucci

Giampietro²

2012

CDR

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“…significant feature during the afternoon, where this feature is usually considered as an accurate reflection of the activity of the sympathetic nervous system [37], [38]. Furthermore, the afternoon time-period is known in literature for a slight increase in the overall blood pressure [39]. On the other hand, during the evening, features such as LF Power and VLF Power were identified significant.…”

Section: A Anova Test Observationsmentioning

confidence: 99%

Predicting Hypertensive Patients With Higher Risk of Developing Vascular Events Using Heart Rate Variability and Machine Learning

et al. 2020

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The prognosis of cardiovascular and cerebrovascular events for patients suffering from hypertension is considered of a high importance in preventing any further development of cardiac diseases. Despite of the ability of current gold standard techniques in predicting vascular events risks, they still lack the required clinical efficiency. In this vein, the study proposed herein provides an investigation on the feasibility of using heart rate variability (HRV) utilized through a machine learning approach to predict hypertensive patients at higher risk of developing vascular events. Initially, HRV features were extracted from all patient's data using time-domain, frequency-domain, non-linear, and fragmentation metrics. The extraction of features was based on a 24-hour cycle analysis segmented into four time periods; namely late-night, early-morning, afternoon, and evening. Analysis of all features was performed using a one-way analysis of variance (ANOVA) test on period by period basis. Furthermore, the selection of best features was performed following a Chi-squared test for demographic and HRV features. Then, a model based on decision trees and random under-sampling boosting (RUSBOOST) was trained using demographic features, HRV features, and a combination of both features. The performance of the trained model achieved a maximum accuracy of 97.08% using the combined set of features during the afternoon time period. In addition, the precision and F1-score in predicting high risk patients reached 81.25% and 86.67%, respectively. The overall area under the curve for the model was at 0.98, suggesting a high performance in the sensitivity and specificity measures. This study paves the way towards utilizing machine learning models and heart rate variability for the prognosis of vascular events in hypertensive patient. Furthermore, it assists clinicians in decision making by providing a simple, yet effective, and continuous prediction approach when compared to other available techniques. INDEX TERMS hypertension, cardiovascular events, cerebrovascular events, heart rate variability, ANOVA, machine learning, feature selection, RUSBOOST

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“…ABPM enables the detection of alterations in BP homeostasis not detected in the ambulatory setting [9,10]. The use of ABPM is especially relevant considering that food consumption varies during the day, in both amount and quality.…”

Section: Discussionmentioning

confidence: 98%

“…ABPM allows a more detailed evaluation of BP pattern and is considered the gold standard of BP assessment [9][10][11][12]. Therefore, the aim of the present study was to analyze the possible associations of dietary components with BP levels during ABPM in patients with type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

Increased Protein Intake Is Associated With Uncontrolled Blood Pressure by 24-Hour Ambulatory Blood Pressure Monitoring in Patients With Type 2 Diabetes

Mattos

Viana

Paula

et al. 2015

Journal of the American College of Nutrition

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Afternoon Blood Pressure Increase: A Blood Pressure Pattern Associated With Microvascular Complications in Type 2 Diabetes Mellitus

Abstract: An increment in afternoon BP was observed in type 2 diabetic patients regardless of hypertension status; that increment was associated with higher prevalence of DR but not diabetic nephropathy independently of measured confounders.

Cited by 9 publications

References 23 publications

Circadian Rhythm of Blood Pressure in Diabetes Mellitus: Evidence, Mechanisms and Implications

Circadian Rhythm of Blood Pressure in Diabetes Mellitus: Evidence, Mechanisms and Implications

Predicting Hypertensive Patients With Higher Risk of Developing Vascular Events Using Heart Rate Variability and Machine Learning

Increased Protein Intake Is Associated With Uncontrolled Blood Pressure by 24-Hour Ambulatory Blood Pressure Monitoring in Patients With Type 2 Diabetes

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