ECE2015 Eposter Presentations Diabetes (complications & therapy) (143 abstracts)
Nocturnal blood pressure is related to the development of microalbuminuria and established hypertension in patients with type 1 diabetes
Francisco Javier Vílchez-López 1 , Isabel Mateo-Gavira 1 , Laura Larrán-Escandón 1 , Ana Montero-Galván 1 , José Ortego-Rojo 1 , María Victoria García-Palacios 2 & Manuel Aguilar-Diosdado 1
1Endocrinology, Puerta del Mar Hospital, Cádiz, Spain; 2Preventive Medicine and Public Health, Puerta del Mar Hospital, Cádiz, Spain.
Introduction: The objective is to evaluate the relationship between early blood pressure alterations (detected by ambulatory blood pressure monitoring (abpm)) and the development of microalbuminuria and arterial hypertension in patients with type 1 diabetes clinically normotensive.
Methods: We designed a prospective observational study of 85 patients, clinically normotensive and without microalbuminuria, monitored over 7 years. Abpm was performed over 24 h and subclinical hypertension was considered if: i) mean systolic pressure (sbp) was >130 mmHg in the 24 h and daytime periods and >120 mmHg in the nighttime period and/or mean diastolic pressure (dbp) >80 or 70 mmHg in the same periods respectively and/or ii) more than 50% of the readings were higher than the defined previous criteria. Non-dipper pattern was defined as nocturnal sbp or dbp <10% relative to the diurnal mean value. We evaluated the development of microalbuminuria and established hypertension during the following period.
Results: Of the 85 patients included in the analysis, 55.3% (n: 47) were women with an average age of 27.9±6.1 years and a length of disease of 12.3±6.5 years. 23.5% were diagnosed with subclinical hypertension and 36% with non-dipper pattern as the only pathological finding. 69 patients completed the 7-year study. During this period: i) 10.14% developed microalbuminuria, showing the mean nocturnal sbp as a risk factor (OR: 1.129, P: 0.007) and ii) 7.24% of the normotensive patients progressed to established hypertension, showing historical HbA1c (OR: 2.767, P: 0.046) and mean nocturnal dbp (OR: 1.243, P: 0.046) as related factors.
Conclusions: In type 1 diabetic patients clinically normotensive with normoalbuminuria, nocturnal blood pressure parameters predisposes the development of microalbuminuria and established hypertension.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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