Short-term reproducibility of a non-dipping pattern in type 2 diabetic hypertensive patients
BACKGROUNDLittle information is available on the reproducibility of nocturnal variations in blood pressure in type 2 diabetic hypertensive patients. OBJECTIVEWe aimed to compare the intrasubject short-term reproducibility of a nocturnal non-dipping pattern and the prevalence of cardiac and extracard...
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| Veröffentlicht in: | Journal of hypertension 2006-04, Vol.24 (4), p.647-653 |
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| creator | Cuspidi, Cesare Meani, Stefano Lonati, Laura Fusi, Veronica Valerio, Cristiana Sala, Carla Magnaghi, Gaia Maisaidi, Meilikemu Zanchetti, Alberto |
| description | BACKGROUNDLittle information is available on the reproducibility of nocturnal variations in blood pressure in type 2 diabetic hypertensive patients.
OBJECTIVEWe aimed to compare the intrasubject short-term reproducibility of a nocturnal non-dipping pattern and the prevalence of cardiac and extracardiac signs of target organ damage, in a group of type 2 diabetic hypertensive patients and in an age/gender-matched group of non-diabetic hypertensive subjects.
METHODSThirty-six treated hypertensive patients with long-lasting type 2 diabetes (> 10 years duration) consecutively attending our hospital out-patient hypertension clinic (group I; mean age, 65 ± 9 years), and 61 untreated non-diabetic subjects with grade 1 and grade 2 uncomplicated essential hypertension, matched for age and gender, and chosen from patients attending an outpatient clinic (group II; mean age, 65 ± 5 years), were considered for this analysis. All patients underwent blood sampling for routine blood chemistry, 24-h urine collection for microalbuminuria, two 24-h periods of ambulatory blood pressure monitoring (ABPM) within a 4-week period, echocardiography, and carotid ultrasonography. A dipping pattern was defined as a greater than 10% reduction in the average systolic and diastolic blood pressure at night compared with average daytime values.
RESULTSA reproducible nocturnal dipping and non-dipping profile was found in 11 (30.6%) and 21 (58.3%) diabetic patients, respectively; while only in four (11.1%) patients was a variable dipping profile observed. Of the 23 patients with a non-dipping pattern during the first ABPM period, 21 (91.3%) also had this type of pattern during the second ABPM recording. In group II (non-diabetic hypertensive patients), 30 patients (49.2%, P < 0.05) had a dipping pattern, 13 patients (21.3%, P < 0.01) had a non-dipping profile pattern and 18 patients (29.5%, P < 0.01) had a variable dipping pattern. Of the 20 patients with a non-dipping pattern during the first ABPM period, 13 (65.0%) confirmed this type of pattern during the second ABPM recording. Finally, the prevalence of left ventricular hypertrophy (77.7 versus 41.4%, P < 0.01), carotid plaques (80.5 versus 38.3%, P < 0.01), carotid intima–media thickening (54.3 versus 44.0%, P < 0.05) and microalbuminuria (11.1 versus 2.0%, P < 0.01) was significantly higher in group I than in group II. According to a logistic regression analysis, diabetes, left ventricular hypertrophy and carotid plaques were the main |
| doi_str_mv | 10.1097/01.hjh.0000217846.65089.19 |
| format | Article |
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OBJECTIVEWe aimed to compare the intrasubject short-term reproducibility of a nocturnal non-dipping pattern and the prevalence of cardiac and extracardiac signs of target organ damage, in a group of type 2 diabetic hypertensive patients and in an age/gender-matched group of non-diabetic hypertensive subjects.
METHODSThirty-six treated hypertensive patients with long-lasting type 2 diabetes (> 10 years duration) consecutively attending our hospital out-patient hypertension clinic (group I; mean age, 65 ± 9 years), and 61 untreated non-diabetic subjects with grade 1 and grade 2 uncomplicated essential hypertension, matched for age and gender, and chosen from patients attending an outpatient clinic (group II; mean age, 65 ± 5 years), were considered for this analysis. All patients underwent blood sampling for routine blood chemistry, 24-h urine collection for microalbuminuria, two 24-h periods of ambulatory blood pressure monitoring (ABPM) within a 4-week period, echocardiography, and carotid ultrasonography. A dipping pattern was defined as a greater than 10% reduction in the average systolic and diastolic blood pressure at night compared with average daytime values.
RESULTSA reproducible nocturnal dipping and non-dipping profile was found in 11 (30.6%) and 21 (58.3%) diabetic patients, respectively; while only in four (11.1%) patients was a variable dipping profile observed. Of the 23 patients with a non-dipping pattern during the first ABPM period, 21 (91.3%) also had this type of pattern during the second ABPM recording. In group II (non-diabetic hypertensive patients), 30 patients (49.2%, P < 0.05) had a dipping pattern, 13 patients (21.3%, P < 0.01) had a non-dipping profile pattern and 18 patients (29.5%, P < 0.01) had a variable dipping pattern. Of the 20 patients with a non-dipping pattern during the first ABPM period, 13 (65.0%) confirmed this type of pattern during the second ABPM recording. Finally, the prevalence of left ventricular hypertrophy (77.7 versus 41.4%, P < 0.01), carotid plaques (80.5 versus 38.3%, P < 0.01), carotid intima–media thickening (54.3 versus 44.0%, P < 0.05) and microalbuminuria (11.1 versus 2.0%, P < 0.01) was significantly higher in group I than in group II. According to a logistic regression analysis, diabetes, left ventricular hypertrophy and carotid plaques were the main independent predictors of the non-dipping (pattern in the overall population.
CONCLUSIONSThese findings indicate that intrasubject variability of non-dipper pattern is lower in diabetic than in non-diabetic hypertensive patients, that classification of diabetic hypertensive patients as dipper or non-dipper on the basis of a single ABP recording is more reliable than in non-diabetic patients, and that the more frequent and reproducible non-dipping (pattern in diabetic patients is associated with a more prominent cardiac and extracardiac target organ damage.]]></description><identifier>ISSN: 0263-6352</identifier><identifier>EISSN: 1473-5598</identifier><identifier>DOI: 10.1097/01.hjh.0000217846.65089.19</identifier><identifier>PMID: 16531792</identifier><identifier>CODEN: JOHYD3</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Aged ; Albuminuria - metabolism ; Antihypertensive agents ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Blood Pressure Monitoring, Ambulatory - methods ; Cardiology. Vascular system ; Cardiovascular system ; Carotid Arteries - diagnostic imaging ; Circadian Rhythm ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - physiopathology ; Echocardiography ; Female ; Heart Ventricles - pathology ; Heart Ventricles - physiopathology ; Humans ; Hypertension - complications ; Hypertension - metabolism ; Hypertension - physiopathology ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Reproducibility of Results ; Time Factors</subject><ispartof>Journal of hypertension, 2006-04, Vol.24 (4), p.647-653</ispartof><rights>2006 Lippincott Williams & Wilkins, Inc.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3739-6fc8aca9190d0edd1d464e3f4d01379c242364c38896625d7196894ce679a3ff3</citedby><cites>FETCH-LOGICAL-c3739-6fc8aca9190d0edd1d464e3f4d01379c242364c38896625d7196894ce679a3ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17614620$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16531792$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cuspidi, Cesare</creatorcontrib><creatorcontrib>Meani, Stefano</creatorcontrib><creatorcontrib>Lonati, Laura</creatorcontrib><creatorcontrib>Fusi, Veronica</creatorcontrib><creatorcontrib>Valerio, Cristiana</creatorcontrib><creatorcontrib>Sala, Carla</creatorcontrib><creatorcontrib>Magnaghi, Gaia</creatorcontrib><creatorcontrib>Maisaidi, Meilikemu</creatorcontrib><creatorcontrib>Zanchetti, Alberto</creatorcontrib><title>Short-term reproducibility of a non-dipping pattern in type 2 diabetic hypertensive patients</title><title>Journal of hypertension</title><addtitle>J Hypertens</addtitle><description><![CDATA[BACKGROUNDLittle information is available on the reproducibility of nocturnal variations in blood pressure in type 2 diabetic hypertensive patients.
OBJECTIVEWe aimed to compare the intrasubject short-term reproducibility of a nocturnal non-dipping pattern and the prevalence of cardiac and extracardiac signs of target organ damage, in a group of type 2 diabetic hypertensive patients and in an age/gender-matched group of non-diabetic hypertensive subjects.
METHODSThirty-six treated hypertensive patients with long-lasting type 2 diabetes (> 10 years duration) consecutively attending our hospital out-patient hypertension clinic (group I; mean age, 65 ± 9 years), and 61 untreated non-diabetic subjects with grade 1 and grade 2 uncomplicated essential hypertension, matched for age and gender, and chosen from patients attending an outpatient clinic (group II; mean age, 65 ± 5 years), were considered for this analysis. All patients underwent blood sampling for routine blood chemistry, 24-h urine collection for microalbuminuria, two 24-h periods of ambulatory blood pressure monitoring (ABPM) within a 4-week period, echocardiography, and carotid ultrasonography. A dipping pattern was defined as a greater than 10% reduction in the average systolic and diastolic blood pressure at night compared with average daytime values.
RESULTSA reproducible nocturnal dipping and non-dipping profile was found in 11 (30.6%) and 21 (58.3%) diabetic patients, respectively; while only in four (11.1%) patients was a variable dipping profile observed. Of the 23 patients with a non-dipping pattern during the first ABPM period, 21 (91.3%) also had this type of pattern during the second ABPM recording. In group II (non-diabetic hypertensive patients), 30 patients (49.2%, P < 0.05) had a dipping pattern, 13 patients (21.3%, P < 0.01) had a non-dipping profile pattern and 18 patients (29.5%, P < 0.01) had a variable dipping pattern. Of the 20 patients with a non-dipping pattern during the first ABPM period, 13 (65.0%) confirmed this type of pattern during the second ABPM recording. Finally, the prevalence of left ventricular hypertrophy (77.7 versus 41.4%, P < 0.01), carotid plaques (80.5 versus 38.3%, P < 0.01), carotid intima–media thickening (54.3 versus 44.0%, P < 0.05) and microalbuminuria (11.1 versus 2.0%, P < 0.01) was significantly higher in group I than in group II. According to a logistic regression analysis, diabetes, left ventricular hypertrophy and carotid plaques were the main independent predictors of the non-dipping (pattern in the overall population.
CONCLUSIONSThese findings indicate that intrasubject variability of non-dipper pattern is lower in diabetic than in non-diabetic hypertensive patients, that classification of diabetic hypertensive patients as dipper or non-dipper on the basis of a single ABP recording is more reliable than in non-diabetic patients, and that the more frequent and reproducible non-dipping (pattern in diabetic patients is associated with a more prominent cardiac and extracardiac target organ damage.]]></description><subject>Aged</subject><subject>Albuminuria - metabolism</subject><subject>Antihypertensive agents</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood Pressure - physiology</subject><subject>Blood Pressure Monitoring, Ambulatory - methods</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Carotid Arteries - diagnostic imaging</subject><subject>Circadian Rhythm</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Heart Ventricles - pathology</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - metabolism</subject><subject>Hypertension - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Reproducibility of Results</subject><subject>Time Factors</subject><issn>0263-6352</issn><issn>1473-5598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkFtrFDEUgINY7Lb6FyQI-pZpbpOLb1LUCgUfbN-EkE0yTupsZkwylv33Zt2FPS-Hc_jOhQ-AdwR3BGt5g0k3Po0dbkGJVFx0osdKd0S_ABvCJUN9r9VLsMFUMCRYTy_BVSlPjVdaslfgkoieEanpBvz8Mc65ohryDuaw5NmvLm7jFOsezgO0MM0J-bgsMf2Ci60NTDAmWPdLgBT6aLehRgfHVucaUol_w4GLIdXyGlwMdirhzSlfg8cvnx9u79D996_fbj_dI8ck00gMTllnNdHY4-A98VzwwAbuMWFSO8opE9wxpbQQtPeSaKE0d0FIbdkwsGvw4bi3_f9nDaWaXSwuTJNNYV6LEVJy0kvZwI9H0OW5lBwGs-S4s3lvCDYHtwYT09yas1vz360hug2_PV1Zt7vgz6MnmQ14fwJscXYask0uljMnBeGC4sbxI_c8T81n-T2tzyGbMdipHk9zJSmiGAvMW4UOLc3-ARYRkwg</recordid><startdate>200604</startdate><enddate>200604</enddate><creator>Cuspidi, Cesare</creator><creator>Meani, Stefano</creator><creator>Lonati, Laura</creator><creator>Fusi, Veronica</creator><creator>Valerio, Cristiana</creator><creator>Sala, Carla</creator><creator>Magnaghi, Gaia</creator><creator>Maisaidi, Meilikemu</creator><creator>Zanchetti, Alberto</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200604</creationdate><title>Short-term reproducibility of a non-dipping pattern in type 2 diabetic hypertensive patients</title><author>Cuspidi, Cesare ; Meani, Stefano ; Lonati, Laura ; Fusi, Veronica ; Valerio, Cristiana ; Sala, Carla ; Magnaghi, Gaia ; Maisaidi, Meilikemu ; Zanchetti, Alberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3739-6fc8aca9190d0edd1d464e3f4d01379c242364c38896625d7196894ce679a3ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Albuminuria - metabolism</topic><topic>Antihypertensive agents</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood Pressure - physiology</topic><topic>Blood Pressure Monitoring, Ambulatory - methods</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Carotid Arteries - diagnostic imaging</topic><topic>Circadian Rhythm</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Heart Ventricles - pathology</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - metabolism</topic><topic>Hypertension - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Reproducibility of Results</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cuspidi, Cesare</creatorcontrib><creatorcontrib>Meani, Stefano</creatorcontrib><creatorcontrib>Lonati, Laura</creatorcontrib><creatorcontrib>Fusi, Veronica</creatorcontrib><creatorcontrib>Valerio, Cristiana</creatorcontrib><creatorcontrib>Sala, Carla</creatorcontrib><creatorcontrib>Magnaghi, Gaia</creatorcontrib><creatorcontrib>Maisaidi, Meilikemu</creatorcontrib><creatorcontrib>Zanchetti, Alberto</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cuspidi, Cesare</au><au>Meani, Stefano</au><au>Lonati, Laura</au><au>Fusi, Veronica</au><au>Valerio, Cristiana</au><au>Sala, Carla</au><au>Magnaghi, Gaia</au><au>Maisaidi, Meilikemu</au><au>Zanchetti, Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short-term reproducibility of a non-dipping pattern in type 2 diabetic hypertensive patients</atitle><jtitle>Journal of hypertension</jtitle><addtitle>J Hypertens</addtitle><date>2006-04</date><risdate>2006</risdate><volume>24</volume><issue>4</issue><spage>647</spage><epage>653</epage><pages>647-653</pages><issn>0263-6352</issn><eissn>1473-5598</eissn><coden>JOHYD3</coden><abstract><![CDATA[BACKGROUNDLittle information is available on the reproducibility of nocturnal variations in blood pressure in type 2 diabetic hypertensive patients.
OBJECTIVEWe aimed to compare the intrasubject short-term reproducibility of a nocturnal non-dipping pattern and the prevalence of cardiac and extracardiac signs of target organ damage, in a group of type 2 diabetic hypertensive patients and in an age/gender-matched group of non-diabetic hypertensive subjects.
METHODSThirty-six treated hypertensive patients with long-lasting type 2 diabetes (> 10 years duration) consecutively attending our hospital out-patient hypertension clinic (group I; mean age, 65 ± 9 years), and 61 untreated non-diabetic subjects with grade 1 and grade 2 uncomplicated essential hypertension, matched for age and gender, and chosen from patients attending an outpatient clinic (group II; mean age, 65 ± 5 years), were considered for this analysis. All patients underwent blood sampling for routine blood chemistry, 24-h urine collection for microalbuminuria, two 24-h periods of ambulatory blood pressure monitoring (ABPM) within a 4-week period, echocardiography, and carotid ultrasonography. A dipping pattern was defined as a greater than 10% reduction in the average systolic and diastolic blood pressure at night compared with average daytime values.
RESULTSA reproducible nocturnal dipping and non-dipping profile was found in 11 (30.6%) and 21 (58.3%) diabetic patients, respectively; while only in four (11.1%) patients was a variable dipping profile observed. Of the 23 patients with a non-dipping pattern during the first ABPM period, 21 (91.3%) also had this type of pattern during the second ABPM recording. In group II (non-diabetic hypertensive patients), 30 patients (49.2%, P < 0.05) had a dipping pattern, 13 patients (21.3%, P < 0.01) had a non-dipping profile pattern and 18 patients (29.5%, P < 0.01) had a variable dipping pattern. Of the 20 patients with a non-dipping pattern during the first ABPM period, 13 (65.0%) confirmed this type of pattern during the second ABPM recording. Finally, the prevalence of left ventricular hypertrophy (77.7 versus 41.4%, P < 0.01), carotid plaques (80.5 versus 38.3%, P < 0.01), carotid intima–media thickening (54.3 versus 44.0%, P < 0.05) and microalbuminuria (11.1 versus 2.0%, P < 0.01) was significantly higher in group I than in group II. According to a logistic regression analysis, diabetes, left ventricular hypertrophy and carotid plaques were the main independent predictors of the non-dipping (pattern in the overall population.
CONCLUSIONSThese findings indicate that intrasubject variability of non-dipper pattern is lower in diabetic than in non-diabetic hypertensive patients, that classification of diabetic hypertensive patients as dipper or non-dipper on the basis of a single ABP recording is more reliable than in non-diabetic patients, and that the more frequent and reproducible non-dipping (pattern in diabetic patients is associated with a more prominent cardiac and extracardiac target organ damage.]]></abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>16531792</pmid><doi>10.1097/01.hjh.0000217846.65089.19</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of hypertension, 2006-04, Vol.24 (4), p.647-653 |
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| subjects | Aged Albuminuria - metabolism Antihypertensive agents Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Blood Pressure - physiology Blood Pressure Monitoring, Ambulatory - methods Cardiology. Vascular system Cardiovascular system Carotid Arteries - diagnostic imaging Circadian Rhythm Clinical manifestations. Epidemiology. Investigative techniques. Etiology Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - physiopathology Echocardiography Female Heart Ventricles - pathology Heart Ventricles - physiopathology Humans Hypertension - complications Hypertension - metabolism Hypertension - physiopathology Male Medical sciences Middle Aged Pharmacology. Drug treatments Reproducibility of Results Time Factors |
| title | Short-term reproducibility of a non-dipping pattern in type 2 diabetic hypertensive patients |
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