Titre du document / Document title

Pulse pressure and diurnal l blood pressure variation: Association with micro- and macrovascular complications in type 2 diabetes

Auteur(s) / Author(s)

KNUDSEN Siren Tang ⁽¹⁾ ; POULSEN Per Løgstrup ⁽¹⁾ ; HANSEN Klavs Würgler ⁽¹⁾ ; EBBEHØJ Eva ⁽¹⁾ ; BEK Toke ⁽²⁾ ; MOGENSEN Carl Erik ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Medical Department M (Diabetes & Endocrinology), Aarhus Kommune-hospital, Aarhus, DANEMARK
⁽²⁾ Eye Department, Aarhus Kommune-hospital, Aarhus, DANEMARK

Résumé / Abstract

Background: In nondiabetic subjects pulse pressure (PP) is an independent predictor of cardiovascular disease and microalbuminuria. Reduced circadian blood pressure (BP) variation is a potential risk factor for the development of diabetic complications. We investigated the association between retinopathy, nephropathy, macrovascular disease, PP, and diurnal BP variation in a group of type 2 diabetic patients. Methods: In 80 type 2 diabetic patients we performed 24-h ambulatory BP (AMBP) and fundus photographs. Urinary albumin excretion was evaluated by urinary albumin/creatinine ratio. Presence or absence of macrovascular disease was assessed by an independent physician. Results: Forty-nine patients had no detectable retinal changes (grade 1), 13 had grade 2 retinopathy, and 18 had more advanced retinopathy (grades 3-6). Compared to patients without retinopathy (grade 1), patients with grades 2 and 3-6 had higher PP and blunted diurnal BP variation: night PP 55 ± 10 mm Hg, 64 ± 10 mm Hg, 61 ± 15 mm Hg, P <.05 and systolic night/day ratio 89.3% ± 7%, 94.6% ± 8%, and 92.0% ± 6%, P <.05 (grade 1, 2, and 3-6, respectively). Comparing nephropathy groups (45 normo-, 19 micro-, and 15 macroalbuminuric patients) results were similar: night PP 54 ± 9 mm Hg, 57 ± 10 mm Hg, and 70 ± 15 mm Hg, P <.001 and systolic night/day ratio 88.9% ± 7%, 92.0% ± 7%, and 94.9% ± 7%, P < .02. Likewise, compared to patients without macrovascular disease (n = 55), patients with this complication (n = 25) had higher AMBP values: night PP 57 ± 12 mm Hg v 63 ± 11 mm Hg, P <.05 and systolic night/day ratio 89.2% ± 6% v 94.1% ± 9%, P <.01. Conclusions: Increased PP and blunted diurnal BP variation are hemodynamic abnormalities associated with micro- and macrovascular complications in type 2 diabetes.

Revue / Journal Title

American journal of hypertension   ISSN 0895-7061 

Source / Source

2002, vol. 15, n^o3, pp. 244-250 (32 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1988) (Revue)

Mots-clés anglais / English Keywords

Kidney disease ; Urinary system disease ; Cardiovascular disease ; Vascular disease ; Eye disease ; Endocrinopathy ; Complication ; Nephropathy ; Hemodynamics ; Risk factor ; Microangiopathy ; Pulse ; Macroangiopathy ; Retinopathy ; Diurnal variation ; Pathophysiology ; Exploration ; Blood pressure ; Human ; Non insulin dependent diabetes ;

Mots-clés français / French Keywords

Rein pathologie ; Appareil urinaire pathologie ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Oeil pathologie ; Endocrinopathie ; Complication ; Néphropathie ; Hémodynamique ; Facteur risque ; Microangiopathie ; Pulsation ; Macroangiopathie ; Rétinopathie ; Variation diurne ; Physiopathologie ; Exploration ; Pression sanguine ; Homme ; Diabète non insulinodépendant ;

Mots-clés espagnols / Spanish Keywords

Riñón patología ; Aparato urinario patología ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Ojo patología ; Endocrinopatía ; Complicación ; Nefropatía ; Hemodinámica ; Factor riesgo ; Microangiopatía ; Pulsación ; Macroangiopatía ; Retinopatía ; Variación diurna ; Fisiopatología ; Exploración ; Presión sanguínea ; Hombre ; Diabetes no insulinodependiente ;

Localisation / Location

INIST-CNRS, Cote INIST : 21579, 35400010033273.0080