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[Decrease of nocturnal blood pressure in type II diabetic subjects with microalbuminuria]

G Berrut1, P Fabbri, B Bouhanick

  • 1Service de médecine B, CHU Angers.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|August 1, 1996
PubMed
Summary
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Hypertensive diabetics with microalbuminuria show a loss of nocturnal blood pressure decrease. This indicates a link between microalbuminuria and abnormal circadian blood pressure patterns in diabetes management.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Microalbuminuria is an early sign of diabetic kidney disease.
  • Circadian blood pressure variations are crucial in cardiovascular risk assessment.
  • Hypertension management in diabetes requires understanding these variations.

Purpose of the Study:

  • To evaluate circadian blood pressure variations in non-insulin dependent diabetic subjects with and without microalbuminuria.
  • To determine if microalbuminuria is associated with altered nocturnal blood pressure dipping patterns.

Main Methods:

  • Ambulatory blood pressure monitoring (ABPM) was used to measure SBP and DBP every 15-30 minutes over 24 hours.
  • Urinary Albumin Excretion (UAE) was measured using nephelometry on three separate 24-hour urine collections.

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  • Subjects were categorized into microalbuminuria (30-300 mg/24h) and normoalbuminuria (<30 mg/24h) groups.

    • Main Results:

    • No significant differences in age, sex, BMI, diabetes duration, or HbA1c between groups.
    • Daytime SBP/DBP and nighttime DBP were comparable.
    • Nighttime SBP was significantly higher in the microalbuminuria group (p=0.016).
    • A significant relationship was found between 'non-dipper' status and microalbuminuria (p=0.017).

    Conclusions:

    • Hypertensive non-insulin dependent diabetic subjects with microalbuminuria exhibit a loss of nocturnal blood pressure reduction.
    • Microalbuminuria is associated with abnormal circadian blood pressure regulation in diabetic patients.
    • These findings highlight the importance of ABPM in managing hypertensive diabetics with early signs of kidney damage.