Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes

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dc.contributor.authorFelicio, Joao S.
dc.contributor.authorSouza, Ana Carolina C. B. de
dc.contributor.authorKohlmann, Narcia [UNIFESP]
dc.contributor.authorKohlmann, Osvaldo [UNIFESP]
dc.contributor.authorRibeiro, Arthur Beltrame [UNIFESP]
dc.contributor.authorZanella, Maria Teresa [UNIFESP]
dc.contributor.institutionUniversidade Federal do Pará (UFPA)
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:05:20Z
dc.date.available2016-01-24T14:05:20Z
dc.date.issued2010-08-13
dc.description.abstractBackground: Hypertensive patients with reduced blood pressure fall (BPF) at night are at higher risk of cardiovascular events (CVE).Methods: We evaluated in hypertensive diabetic patients, if a reduced nocturnal BPF can precedes the development of diabetic nephropathy (DN). We followed 70 patients with normal urinary albumin excretion (UAE) for two years. We performed 24-hours ambulatory BP monitoring in baseline and at the end of the study.Results: Fourteen (20%) patients (GI) developed DN (N = 11) and/or CVE (n = 4). Compared to the remaining 56 patients (GII) in baseline, GI had similar diurnal systolic (SBP) and diastolic BP (DBP), but higher nocturnal SBP (138 +/- 15 vs 129 +/- 16 mmHg; p < 0.05) and DBP (83 +/- 12 vs 75 +/- 11 mmHg; p < 0,05). Basal nocturnal SBP correlated with occurrence of DN and CVE (R = 0.26; P < 0.05) and with UAE at the end of the study (r = 0.3; p < 0.05). Basal BPF (%) correlated with final UAE (r = -0.31; p < 0.05). in patients who developed DN, reductions occurred in nocturnal systolic BPF (12 +/- 5 vs 3 +/- 6%, p < 0,01) and diastolic BPF (15 +/- 8 vs 4 +/- 10%, p < 0,01) while no changes were observed in diurnal SBP (153 +/- 17 vs 156 +/- 16 mmHg, NS) and DBP (91 +/- 9 vs 90 +/- 7 mmHg, NS). Patients with final UAE < 20 mu g/min, had no changes in nocturnal and diurnal BP.Conclusions: Our results suggests that elevations in nocturnal BP precedes DN and increases the risk to develop CVE in hypertensive patients with T2DM.en
dc.description.affiliationFed Univ Para, UFPA, Div Endocrinol, BR-66059 Belem, Para, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, UNIFESP, Endocrinol & Nephrol Div, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, UNIFESP, Endocrinol & Nephrol Div, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent6
dc.identifierhttp://dx.doi.org/10.1186/1475-2840-9-36
dc.identifier.citationCardiovascular Diabetology. London: Biomed Central Ltd, v. 9, 6 p., 2010.
dc.identifier.doi10.1186/1475-2840-9-36
dc.identifier.fileWOS000282267300001.pdf
dc.identifier.issn1475-2840
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32821
dc.identifier.wosWOS:000282267300001
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofCardiovascular Diabetology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleNocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetesen
dc.typeinfo:eu-repo/semantics/article
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