Association between day-by-day and ambulatory blood pressure variability in type 2 diabetes patients
Hiroyuki Iuchi1, Masaya Sakamoto, Daisuke Matsutani
1aDepartment of Internal Medicine, Division of Diabetes, Metabolism and Endocrinology bDepartment of Cardiology, Jikei University School of Medicine cDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Insights
Day-by-day blood pressure variability (BPV) in type 2 diabetes patients is linked to diurnal BPV, not nocturnal BPV. This finding highlights the importance of monitoring daytime blood pressure fluctuations for better diabetes management.
Area of Science:
- Cardiology
- Endocrinology
- Hypertension Research
Background:
- Blood pressure variability (BPV) is a recognized risk factor for type 2 diabetes.
- The relationship between day-by-day BPV and ambulatory BPV, particularly diurnal and nocturnal patterns, remains unclear in type 2 diabetes patients.
Purpose of the Study:
- To investigate the association between day-by-day BPV and ambulatory BPV in type 2 diabetes patients.
- To differentiate the contribution of diurnal versus nocturnal ambulatory BPV to day-by-day BPV.
Main Methods:
- Thirty type 2 diabetes patients were enrolled in inpatient settings.
- Day-by-day and ambulatory BPV were assessed, with specific attention to diurnal and nocturnal systolic BPV.
- Correlation and multiple regression analyses were performed to determine associations.
Main Results:
- Day-by-day systolic BPV showed a significant positive correlation with diurnal systolic BPV (r=0.426, P=0.019).
- No significant correlation was found between day-by-day systolic BPV and nocturnal systolic BPV (r=0.175, P=0.354).
- Multiple regression identified diurnal systolic BPV and diurnal mean systolic blood pressure as independent predictors of day-by-day systolic BPV.
Conclusions:
- Day-by-day BPV in type 2 diabetes is primarily associated with diurnal ambulatory BPV.
- Nocturnal BPV does not significantly contribute to day-by-day BPV in this patient group.
- These findings suggest that diurnal blood pressure monitoring is crucial for understanding day-by-day BPV in type 2 diabetes.
Abstract:
It remains unclear whether ambulatory blood pressure variability (BPV) contributes toward day-by-day BPV, despite the fact that not only day-by-day but also ambulatory BPV is reported to be a risk factor for type 2 diabetes patients. This study aimed to determine the association between day-by-day BPV and ambulatory BPV, which is especially distinguished between diurnal and nocturnal BPV, in type 2 diabetes patients. Day-by-day and ambulatory BPV were assessed in 30 type 2 diabetes patients (aged 54±15 years; 87% men; glycated hemoglobin: 9.1±1.9%) in inpatient settings. Day-by-day systolic BPV was correlated significantly with diurnal systolic BPV (r=0.426, P=0.019), but not nocturnal systolic BPV (r=0.175, P=0.354). Multiple regression analysis showed that diurnal systolic BPV and diurnal mean systolic blood pressure were associated independently with day-by-day systolic BPV. With respect to type 2 diabetes, these findings suggest that day-by-day BPV is reflected in diurnal BPV rather than nocturnal BPV.
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