Endocrine Abstracts

Objectives: To evaluate the validity as diagnostic test of isolated blood pressure measurement compared to 24 h ambulatory blood pressure monitoring (ABPM) in a group of clinically normotensive patients with type 1 diabetes (TDM1).

Methods: Cross-sectional study including 85 normotensive and normoalbuminuric patients with TDM1. Media of two blood pressure measures by conventional technique and results of the 24 h blood pressure monitoring (SPACELABS 90217) were compared. Altered ABPM was considered when: 1) Mean systolic pressure (sBP) was greater than 130 mmHg in the 24 h and daytime periods and greater than 120 mmHg in the night-time period and/or mean diastolic pressure (dBP) greater than 80 or 70 mmHg in the same periods respectively, and/or 2) More than 50% of the readings were higher than the defined previous criteria, and/or 3) Nocturnal fall in either sBP or dBP was lower than 10% (non-dippers).

Results: Eighty-five patients, 55% women, aged 27.9±6.1 years and 12.3±6.5 years of disease evolution. The maximum sensitivity of the conventional technique (systolic and diastolic records) to detect any ABPM disturbances was less than 75%, and almost zero for the presence of a non-dipper pattern. However, the specificity was higher, almost always above 85%.

Conclusions: Isolated blood pressure (systolic or diastolic) as a diagnostic test showed high specificity but low sensitivity, so this measure may not be suitable as a screening method for hypertension in normotensive and normoalbuminuric patients with type 1 diabetes. Criteria to perform ABPM in this patients should be defined to detect subclinical blood pressure alterations and to assess the convenience of drug treatment.