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Influence of HbA1c on short-term blood pressure variability in type 2 diabetic patients with diabetic nephropathy

Fang Liu1, Min Wu, Yan-huan Feng

  • 1Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China.

Journal of Zhejiang University. Science. B
|November 6, 2013
PubMed

Insights

Hypertensive patients with diabetic nephropathy exhibit higher blood pressure (BP) variability. Better glycemic control, indicated by lower hemoglobin A1c, may reduce BP variability in these patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Diabetic nephropathy (DN) is a common complication of type 2 diabetes, often associated with hypertension.
  • Understanding blood pressure (BP) variability is crucial for managing cardiovascular risk in patients with chronic kidney disease (CKD).

Purpose of the Study:

  • To characterize short-term BP variability in hypertensive patients with DN.
  • To identify predictors of BP variability in this population.

Main Methods:

  • Compared 24-hour ambulatory BP monitoring (ABPM) data between 51 CKD-hypertensive patients without diabetes (NDN) and 60 type 2 diabetic patients with DN.
  • Analyzed BP variability based on glycated hemoglobin (HbA1c) levels within the DN group.
  • Utilized variance analysis, nonparametric analysis, and partial correlation analysis.

Main Results:

  • The DN group showed significantly higher 24-h systolic BP variability and nighttime systolic BP variability than the NDN group.
  • Patients with HbA1c ≥7% (Group B) had greater 24-h diastolic, daytime diastolic, and nighttime systolic/diastolic BP variability compared to those with HbA1c <7% (Group A).
  • HbA1c strongly correlated with 24-h diastolic, daytime diastolic, and nighttime systolic/diastolic BP variability in the DN group.

Conclusions:

  • Hypertensive patients with type 2 diabetes and overt nephropathy exhibit increased short-term BP variability.
  • Improved glycemic control (lower HbA1c) is associated with reduced BP variability in patients with diabetic nephropathy.
  • Targeting BP variability may be a beneficial strategy in managing diabetic nephropathy.

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