Late afternoon blood pressure increase is associated with diabetic retinopathy in normotensive type 2 diabetes mellitus patients

Abstract Aims To identify if the variability of blood pressure (BP) is associated with diabetic retinopathy (DR) in normotensive type 2 DM patients. Methods Sixty-five normotensive type 2 DM patients that had 24-h ambulatory BP monitoring (ABPM) were grouped according any degree of DR. Results Fourteen (21%) patients had DR. Office BP and 24-h BP parameters did not differ between groups. At late afternoon period, patients with DR had higher increment in both systolic (11.3 ± 12.7 mmHg vs. 1.0 ± 11.4 mmHg, P = 0.006) and diastolic (6.7 ± 8.6 mmHg vs. −0.73 ± 10.0 mmHg, P = 0.017) BP levels than those without. Multivariate logistic analyses were performed with DR as a dependent variable. Each 1 mmHg increment in systolic BP at the late afternoon period was associated with a 10.2% increase in DR prevalence [OR 1.102 (CI 95% 1.011–1.202, P = 0.027)], after adjustments for A1C test, DM duration, age, albuminuria and current smoking. Conclusions In conclusion, in normotensive type 2 DM patients, BP increase at late afternoon is associated to DR independently from confounder factors or other ABPM parameters.