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Night Blood Pressure: Relation to Organ Lesions in Microalbuminuric Type 1 Diabetic Patients
Author(s) -
Hansen K. W.,
Sørensen K.,
Christensen P. D.,
Pedersen E. B.,
Christiansen J. S.,
Mogensen C. E.
Publication year - 1995
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1995.tb02060.x
Subject(s) - medicine , aldosterone , ambulatory blood pressure , blood pressure , endocrinology , renal function , vasopressin , cardiology , mean arterial pressure , urology , heart rate
Ambulatory blood pressure was measured in 23 microalbuminuric Type 1 diabetic patients without hypertension. Nine patients had a reduction in mean arterial blood (MAP) pressure at night < 10% of their day‐time value (non‐dippers). The following parameters were measured: glomerular filtration rate (GFR), overnight urinary excretion of albumin (UAE), sodium and potassium, left ventricular dimensions, extracellular volume (ECV), plasma aldosterone, and arginine vasopressin (AVP). Night‐time MAP was 11 mmHg lower in patients designated as dippers than in non‐dippers. Day‐time MAP was similar in dippers (98 ± 5 mmHg) and non‐dippers (99 ± 8 mmHg, NS). No statistical significant difference was found for UAE in dippers (geometric mean, x/– tolerance factor, μg min ‐1 ) (72 x/– 2.1) vs non‐dippers (63 x/– 2.1), for left ventricular mass index (63 ± 12 vs 59 ± 10 g m ‐2 ), or for GFR (134 ± 19 vs 148 ± 22 ml min ‐1 ). Aldosterone and AVP were lower in non‐dippers ( p < 0.05) and a negative correlation in all patients was noticed between ECV and aldosterone (rho = −0.50, p < 0.05). Sodium and potassium excretion and ECV were indistinguishable between the groups. We conclude (1) that impaired reduction of night blood pressure does not seem to be associated with more signs of renal or cardiac lesions and (2) that the lower aldosterone and AVP in non‐dippers may counteract volume expansion.