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Zigzagged augmentation index in diabetes
Tsuneo Takenaka1, Takahiko Sato, Hitoshi Hoshi
1Department of Nephrology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama, Iruma, Saitama, Japan.
Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|December 17, 2009
Summary
Augmentation index (AI) is reduced in diabetic nephropathy patients due to autonomic dysfunction, impacting blood pressure regulation. Supine AI may help detect cardiovascular risk in this population.
Area of Science:
- Cardiology
- Nephrology
- Vascular Physiology
Background:
- Diabetic nephropathy patients face high cardiovascular risk.
- Augmentation index (AI) in diabetic nephropathy is not well understood.
- Autonomic dysfunction is common in diabetes.
Purpose of the Study:
- To characterize augmentation index (AI) in patients with diabetic nephropathy.
- To investigate the relationship between AI, blood pressure, and autonomic function in diabetic nephropathy.
- To determine if AI can serve as a cardiovascular risk marker in diabetic nephropathy.
Main Methods:
- Cross-sectional study comparing 26 diabetic and 27 nondiabetic nephropathic patients.
- Home blood pressure monitoring and in-clinic measurements (blood pressure, pulse rate, AI) in supine and sitting positions.
- Multivariate regression analysis to identify correlations.
Main Results:
- Diabetic patients showed lost circadian blood pressure variation and greater systolic blood pressure (SBP) and AI decrements upon sitting.
- AI in supine position correlated positively with age, diabetes presence, and SBP.
- AI in sitting position correlated positively with SBP and inversely with pulse rate.
Conclusions:
- Patients with diabetic nephropathy exhibit autonomic dysfunction.
- Autonomic dysfunction leads to inadequate arterial response to postural changes, reducing AI and causing SBP fall.
- Supine AI, not sitting AI, is a potential marker for cardiovascular risk in diabetic nephropathy.
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