Circadian Rhythm of Blood Pressure in Normotensive NIDDM Subjects: Its Relationship to Microvascular Complications

Nakano, Shigeru; Uchida, Keiji; Kigoshi, Toshikazu; Azukizawa, Sadahide; Iwasaki, Ryoji; Kaneko, Mihoko; Morimoto, Shinji

doi:10.2337/diacare.14.8.707

Cited by 64 publications

(46 citation statements)

References 15 publications

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“…The association we found among autonomic neuropathy, UAER, and 24-h AMBP levels and variation is compatible with previous findings in type 2 diabetes (13,14). Our findings of autonomic neuropathy in nondiabetic subjects with a predisposition to type 2 diabetes are supported by a recent study demonstrating parasympathetic neuropathy in subjects with IGT (23).…”

Section: Discussionsupporting

confidence: 82%

“…The association among microalbuminuria, cardiac autonomic neuropathy, and diurnal blood pressure profile has been studied in type 2 diabetic subjects in the recent years, and the question of a causative relationship has arisen. Studies in type 2 diabetes have shown that abnormal diurnal variation in blood pressure is associated with microalbuminuria and autonomic neuropathy (13,14). Recent studies have shown the urinary albumin excretion rate (UAER) to be related to subclinical autonomic neuropathy in type 2 diabetic subjects (15,16), and a study demonstrated that the presence of autonomic neuropathy was associated with hyperinsulinemia and hypertriglyceridemia (17).…”

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confidence: 99%

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Autonomic Neuropathy in Nondiabetic Offspring of Type 2 Diabetic Subjects Is Associated With Urinary Albumin Excretion Rate and 24-h Ambulatory Blood Pressure

Foss

Vestbo

Frøland³

et al. 2001

Diabetes

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The aim of this study was to examine the impact of parental type 2 diabetes on the autonomic nervous system and to determine whether autonomic neuropathy is present and associated with changes in 24-h ambulatory blood pressure (AMBP) and urinary albumin excretion rate (UAER) in nondiabetic subjects with parental type 2 diabetes. We examined 223 nondiabetic offspring of type 2 diabetic subjects and a control group of 258 offspring of nondiabetic subjects. The autonomic nervous system was assessed by three cardiovascular reflex tests, 24-h AMBP was measured with an oscillometric recorder (90207; Spacelabs, Redmond, WA), and UAER was determined through three overnight urine samples. The subjects with parental type 2 diabetes had significantly lower heart rate variation in all three bedside tests (P < 0.01) than subjects without parental diabetes. The prevalence of autonomic neuropathy in the nondiabetic offspring with parental type 2 diabetes (6.7%) was significantly (P < 0.01) higher compared with the control group (1.6%). Autonomic neuropathy was associated with a higher fasting insulin level (P < 0.05), higher UAER (P < 0.001), higher 24-h mean AMBP (P < 0.01), and reduced diurnal blood pressure variation (P < 0.001) after adjustment for age, sex, and BMI. In conclusion, parental type 2 diabetes was found to be associated with alterations in the autonomic nervous system in nondiabetic subjects. The presence of autonomic neuropathy in subjects with parental type 2 diabetes was associated with higher UAER, fasting insulin level, and 24-h AMBP and a reduced diurnal blood pressure variation. This study indicates that parental type 2 diabetes has an impact on the cardiac autonomic function in nondiabetic subjects. Diabetes 50:630 -636, 2001

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Autonomic Neuropathy in Nondiabetic Offspring of Type 2 Diabetic Subjects Is Associated With Urinary Albumin Excretion Rate and 24-h Ambulatory Blood Pressure

Foss

Vestbo

Frøland³

et al. 2001

Diabetes

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“…In fact, some diabetic subjects in this study had various degrees of microvascular complications, although they were not severe. We previously reported that autonomic dysfunction, especially orthostatic hypotension, and/or diabetic nephropathy were related to the reversal of diurnal BP rhythm (13), and were even independent predictive factors for nonfatal vascular events (7). Thus, our data suggest that diabetes-specific factors such as duration of diabetes and serum creatinine are stronger predictors than age or sex.…”

Section: Discussionmentioning

confidence: 50%

Ambulatory Blood Pressure Level Rather than Dipper/Nondipper Status Predicts Vascular Events in Type 2 Diabetic Subjects

et al. 2004

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“…Most studies on pressure patterns in DM patients report BP modifications during the 24 hours, even before the diagnosis of SAH 34,35 . The analysis of each one of the ABPM parameters in patients with DM will be discussed in detail below.…”

Section: Blood Pressure Monitoring In Diabetes Mellitus Patientsmentioning

confidence: 99%

Monitorização ambulatorial da pressão arterial e diabete melito tipo 2

Leitão¹,

Canani²,

Silveiro³

et al. 2007

Arq. Bras. Cardiol.

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SummaryHypertension is one of the main risk factors for the onset and progression of chronic complications in type 2 diabetes mellitus (DM).Ambulatory blood pressure (BP) monitoring (ABPM) provides a better correlation with target organ lesions than BP obtained in the office. Furthermore, it allows the evaluation of distinct BP parameters such as the 24-h, daytime and nighttime systolic and diastolic BP means, BP loads and the absence of nocturnal drop of BP, as well as the identification of white-coat and masked hypertension.DM patients have higher daytime and nighttime BP means than non-DM patients. In addition, one third of normotensive type 2 DM patients have masked hypertension, which is associated with an increase in albuminuria and in left ventricle wall thickness. On the other hand, the prevalence and effect of white-coat hypertension in type 2 DM patients have not yet been properly evaluated. The absence of nocturnal drop of BP does not add information to the 24 h, daytime or nighttime BP measurements, but the nighttime BP means seem to be relevant in DM retinopathy.In conclusion, BP determination by ABPM allows better patient risk stratification for the development of DM chronic complications and is an essential instrument for effective BP control in these patients. Arterial pressure and diabetes mellitusType 2 diabetes mellitus (DM) is associated with the development of chronic microvascular and macrovascular complications with high rates of morbidity and mortality 1,2 . The classic and most analyzed risk factors for the development and progression of chronic DM complications are DM duration, hyperglycemia, arterial hypertension (AH), dyslipidemia, and smoking, besides genetic factors [3][4][5][6][7][8] . The treatment of hyperglycemia and SAH results in primary prevention and reduction of the progression of diabetic retinopathy (DR) and diabetic nephropathy (DN) 9,10

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Circadian Rhythm of Blood Pressure in Normotensive NIDDM Subjects: Its Relationship to Microvascular Complications

Abstract: These results suggest that in the hospitalized normotensive NIDDM subjects, there are normal and reversed circadian MBP rhythms and that the reversal of normal circadian MBP rhythm may be related to the degree of postural hypotension and/or nephropathy.

Cited by 64 publications

References 15 publications

Autonomic Neuropathy in Nondiabetic Offspring of Type 2 Diabetic Subjects Is Associated With Urinary Albumin Excretion Rate and 24-h Ambulatory Blood Pressure

Autonomic Neuropathy in Nondiabetic Offspring of Type 2 Diabetic Subjects Is Associated With Urinary Albumin Excretion Rate and 24-h Ambulatory Blood Pressure

Ambulatory Blood Pressure Level Rather than Dipper/Nondipper Status Predicts Vascular Events in Type 2 Diabetic Subjects

Monitorização ambulatorial da pressão arterial e diabete melito tipo 2

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