[24-hour blood pressure measurement in type-2 diabetic patients with and without nephropathy].
24-hour ambulatory blood-pressure measurements were obtained according to criteria of the German Hypertension League in 61 non-insulin-dependent diabetic patients after admission to hospital under clinical routine conditions. 30 patients had no signs of nephropathy; 15 patients showed signs of proteinuria of more than 0.5 g/d and/or renal insufficiency, and 16 patients were on chronic hemodialysis renal replacement therapy. Despite antihypertensive therapy, the majority of NIDDM patients with nephropathy and/or dialysis therapy were hypertensive. Hypertension of non-nephropathic patients showed a better response to therapy. About 50% of all patients with nephropathy had a higher mean arterial blood pressure at night than during the daytime. In about 25% of all diabetics with nephropathy, we found, during night time, an especially pronounced increase of both systolic and diastolic blood pressure of more than 5% above the daytime values. Diabetic patients without nephropathy already show a reduced night/daytime variation of blood pressure, however, inverse circadian rhythm as a sign of prognostically non-favorable autonomic neuropathy was found almost exclusively in the nephropathic diabetic patients.
Schleiffer
T
T
Medizinische Klinik A, Klinikum der Stadt Ludwigshafen.
Klooker
P
P
Brass
H
H
D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D015924:Blood Pressure Monitors; D002940:Circadian Rhythm / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012894:Sleep Stages / Q000502:physiology
24-Stunden-Blutdruckmessung bei Typ-2-Diabetikern mit und ohne Nephropathie.