[Role of nocturnal blood pressure in the onset of diabetic nephropathy]. / Responsabilité de la pression artérielle nocturne dans l'apparition d'une néphropathie chez les diabétiques.
Arch Mal Coeur Vaiss
; 100(8): 668-72, 2007 Aug.
Article
em Fr
| MEDLINE
| ID: mdl-17928773
ABSTRACT
UNLABELLED The aim of this study was to assess the responsibility of night-time blood pressure in the onset of nephropathy in diabetic patients. PATIENTS AND METHODS:
This study included 98 diabetic patients (mean age 54 +/- 15 years, diabetes duration 15 +/- 10 years). An evaluation of diabetes and a 24-h ambulatory blood pressure were performed at the initial evaluation (Y0) and about five years later (Y5). At Y0, all patients had normal urinary albumin excretion (UAE) (<30 mg/24h). They were separated into two groups according to urinary albumin excretion at Y5 group (N +) UAE>30 mg/24h and group (N-) UAE<30 mg/24h. Twenty four hours ambulatory blood pressure, clinical and biological parameters recorded at Y0 were compared in both.RESULTS:
At Y5, there was 18 patients in group (N +) and 78 in group (N-). Patients of group (N +) were older than those of group (N-) 62.9 +/- 9.5 vs. 52.6 +/- 15.7 years, p<0.01, and their BMI was higher (28 +/- 5 vs. 25 +/- 4 kg/m2, p<0.03). Diabetes duration and Hb A1c levels did not differ from significant manner in both. At Y0, UAE was significantly higher in group (N +) than in group (N-) 13 +/- 7 vs. 8 +/- 6 mg/24h, p<0.01. At the initial evaluation, daytime systolic and diastolic blood pressures did not differ from significant manner in both. Systolic and diastolic BP night-time were higher in diabetic patients who developed microalbuminuria (SBP 122 +/- 19 vs. 113 +/- 13 mmHg, p<0.05 and DBP 70 +/- 6 vs. 65 +/- 10 mmHg, p<0.03). UAE collected at Y5 was correlated to night-time BP recorded at Y0 (SBP r=0.381, p=0.001 and PAD r=0.294, p=0.004) and night-time systolic BP explained 12.3% of the UAE variance. Progression of UAE between the two evaluations was found to be correlated to the night-time systolic BP recorded at Y0 (r=0.335, p=0.0008) and night-time systolic BP explained 11.7% of the progression variance. There was a negative correlation between UAE at A5 and the difference between daytime and night-time BP recorded during the same evaluation (r=- 0.230, p=0.024 with SBP and r=- 0.243, p=0.017 with DBP).CONCLUSION:
The results underlign the resposability of night-time blood pressure, and more especially of nighttime systolic blood pressure, for the onset of nephropathy in diabetic patients.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Ritmo Circadiano
/
Nefropatias Diabéticas
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Fr
Revista:
Arch Mal Coeur Vaiss
Ano de publicação:
2007
Tipo de documento:
Article