Impaired nocturnal blood pressure dipping in patients with type 2 diabetes mellitus

Hypertension is a common comorbidity of type 2 diabetes mellitus (T2DM). Both conditions are associated with an increased cardiovascular risk, which is reduced by tight blood pressure (BP) and glycemic control. However, nondipping BP status continues to be an enduring cardiovascular risk factor in T...

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Bibliographic Details
Published in:Hypertension research 2019-01, Vol.42 (1), p.59-66
Main Authors: Kim, Yu-Sok, Davis, Shyrin C A T, Stok, Wim J, van Ittersum, Frans J, van Lieshout, Johannes J
Format: Article
Language:English
Subjects:
Blood pressure
Circadian rhythm
Diabetes
Health risk assessment
Pressure measurement
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Summary:Hypertension is a common comorbidity of type 2 diabetes mellitus (T2DM). Both conditions are associated with an increased cardiovascular risk, which is reduced by tight blood pressure (BP) and glycemic control. However, nondipping BP status continues to be an enduring cardiovascular risk factor in T2DM. Cardiovascular autonomic neuropathy and endothelial dysfunction have been proposed as potential mechanisms. This study tested the hypothesis that microvascular disease rather than cardiovascular autonomic neuropathy interferes with the physiological nocturnal BP reduction. Cardiovascular autonomic function and baroreflex sensitivity were determined in 22 type 2 diabetic patients with (DM+) and 23 diabetic patients without (DM-) manifest microvascular disease. BP dipping status was assessed from 24-hour ambulatory BP measurements. Sixteen nondiabetic subjects served as controls (CTRL). Cardiovascular autonomic function was normal in all subjects. Baroreflex sensitivity was lower in DM- compared with CTRL (7.7 ± 3.3 vs. 12.3 ± 8.3 ms·mm Hg ; P 
ISSN:0916-9636
1348-4214
DOI:10.1038/s41440-018-0130-5