Is non-dipping of nocturnal blood pressure in type 2 diabetes associated with increased incidence of microalbuminuria?:

icroalbuminuria has been associated with Mnon-dipping of nocturnal blood pressure (BP) in people with type 2 diabetes, but the mechanism of this association is unclear. We aimed to identify the development of microalbuminuria in patients with nocturnal non-dipping of BP and type 2 diabetes. Data were examined from 150 people with type 2 diabetes who had undergone ambulatory BP monitoring, non-dippers were defined as those with a systolic nocturnal BP dip less than 10% of the daytime BP.The development of microalbuminuria, over five years of follow-up, in dippers and non-dippers was not significantly different. Non-dippers who were microalbuminuric at baseline were more likely to have a higher body mass index (p=0.01) and to be male (p<0.01).This lack of a difference may be due to the initial exclusion of microalbuminuric patients, who may be genetically predetermined to develop microalbuminuria. Further prospective trials are required to investigate this relationship.

[1]  L. Niskanen,et al.  Aldose reductase gene polymorphisms and susceptibility to microvascular complications in Type 2 diabetes , 2004, Diabetic medicine : a journal of the British Diabetic Association.

[2]  K. Xiang,et al.  Co-inheritance of specific genotypes of HSPG and ApoE gene increases risk of type 2 diabetic nephropathy , 2003, Molecular and Cellular Biochemistry.

[3]  L. Rosivall,et al.  Diurnal blood pressure pattern may predict the increase of urinary albumin excretion in normotensive normoalbuminuric type 1 diabetes mellitus patients. , 2003, Diabetes research and clinical practice.

[4]  M. Kurabayashi,et al.  Angiotensin-Converting Enzyme Gene Polymorphism as a Potent Risk Factor for Developing Microalbuminuria in Japanese Patients with Type 2 Diabetes Mellitus: A 9-Year Follow-up Study , 2003, The Journal of international medical research.

[5]  J. D. Ward,et al.  Autonomic neuropathy is associated with increased cardiovascular risk factors: the EURODIAB IDDM Complications Study , 2002, Diabetic medicine : a journal of the British Diabetic Association.

[6]  J. Redón,et al.  Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. , 2002, The New England journal of medicine.

[7]  K. Kario,et al.  Nocturnal non-dipping: what does it augur? , 2001, Current opinion in nephrology and hypertension.

[8]  F. Magrini,et al.  Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients , 2001, Journal of hypertension.

[9]  N. Pound,et al.  Non‐dipping circadian blood pressure and renal impairment are associated with increased mortality in diabetes mellitus , 2000, Diabetic medicine : a journal of the British Diabetic Association.

[10]  F. Mee,et al.  Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British Hypertension Society , 2000, BMJ : British Medical Journal.

[11]  E. Sandoya,et al.  Ambulatory Blood Pressure , 1999 .

[12]  R. Holman,et al.  Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23) , 1998, BMJ.

[13]  G. Schernthaner,et al.  Nondipping of nocturnal blood pressure is related to urinary albumin excretion rate in patients with type 2 diabetes mellitus. , 1996, American journal of hypertension.

[14]  T. Kigoshi,et al.  Altered circadian blood pressure rhythm and progression of diabetic nephropathy in non-insulin dependent diabetes mellitus subjects: an average three year follow-up study. , 1996, Journal of investigative medicine : the official publication of the American Federation for Clinical Research.

[15]  P. Padfield,et al.  Reduced diurnal variation of blood pressure in non-insulin-dependent diabetic patients with microalbuminuria. , 1995, Journal of human hypertension.

[16]  G. Reboldi,et al.  Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. , 1994, Hypertension.

[17]  G. Parati,et al.  Prognostic Value of Ambulatory Blood Pressure Monitoring , 1994 .

[18]  S. Hollis,et al.  Gender and the Clinical Usefulness of the Albumin:Creatinine Ratio , 1994, Diabetic medicine : a journal of the British Diabetic Association.

[19]  G. Schillaci,et al.  Dippers versus non-dippers. , 1991, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[20]  E B Raftery,et al.  Circadian variation of blood pressure in autonomic failure. , 1983, Circulation.

[21]  P. McNamara,et al.  Morbidity and Mortality in Diabetics In the Framingham Population: Sixteen Year Follow-up Study , 1974, Diabetes.

[22]  J. Redón,et al.  Nocturnal hypertension: Will control of nighttime blood pressure prevent progression of diabetic renal disease? , 2004, Current hypertension reports.

[23]  R. Bigazzi,et al.  Diurnal variations of blood pressure and microalbuminuria in essential hypertension. , 1994, American journal of hypertension.

[24]  R. Zulli,et al.  Relationship between initial cardiovascular structural changes and daytime and nighttime blood pressure monitoring. , 1992, American journal of hypertension.