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Day and night variation in ambulatory blood pressure in type 1 diabetes mellitus with nephropathy and autonomic neuropathy
Author(s) -
TORFFVIT O.,
AGARDH C.D.
Publication year - 1993
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1993.tb00665.x
Subject(s) - medicine , blood pressure , diabetic nephropathy , nephropathy , diabetes mellitus , ambulatory , ambulatory blood pressure , type 2 diabetes , cardiology , heart rate , type 1 diabetes , endocrinology
. The objective was to study ambulatory blood pressure and heart rate variability between day and night in patients with type 1 (insulin‐dependent) diabetes mellitus with different degrees of diabetic nephropathy, and to evaluate the influence of autonomic neuropathy and type of antihypertensive treatment. Twenty type 1 diabetic patients with diabetic nephropathy and antihypertensive treatment were studied with 24‐h ambulatory blood pressure monitoring using an oscillometric method. They were compared with eight insulin‐treated diabetic patients with short duration of diabetes (1–5 years) and with 10 apparently healthy subjects. The degree of autonomic neuropathy was evaluated by measuring the RR‐interval during deep breathing and uprising. The 24‐h blood pressure was generally higher in patients with diabetic nephropathy compared to those other two groups. These patients also had a lower ratio between day and night in diastolic blood pressure compared to the control subjects (1.15 ± 0.12 vs. 1.25 ± 0.76, P < 0.05) and heart rate compared to the diabetic patients without nephropathy, as well as the control subjects (1.15 ± 0.08 vs . 1.26 ± 0.09 vs . 1.27 ± 0.08, P < 0.01, respectively). All patients with diabetic nephropathy had clinical signs of autonomic neuropathy as judged by RR‐interval measurements during deep breathing and uprising.