Altered blood pressure during sleep in normotensive subjects with type I diabetes.
This study was designed to examine the circadian pattern of blood pressure in children and young adults with type I diabetes who were completely normotensive by standard criteria. Forty-five patients and the same number of age- and sex-matched control subjects were studied. In diabetic children of 10-14 years of age, the nocturnal fall in systolic and diastolic blood pressures was intact. In diabetics of 15-20 years of age, the fall in systolic blood pressure was blunted; in diabetics of 21-37 years of age, the fall in both systolic and diastolic blood pressures during sleep was blunted. When data from all diabetic subjects were pooled and analyzed in a multiple linear regression model, mean blood pressure during sleep correlated best with urinary albumin excretion (r = 0.60). On the basis of this finding, we subdivided our patients into two groups: a microalbuminuric group (urinary albumin excretion > 30 mg per 24 hours; mean, 160.3 +/- 29.7; n = 11) and a normoalbuminuric group (urinary albumin excretion < 30 mg per 24 hours; mean, 6.6 +/- 6.5; n = 34). Both systolic and diastolic blood pressures during sleep were higher in microalbuminuric (121.1 +/- 3.3 and 69.3 +/- 2.5 mm Hg, respectively) than in normoalbuminuric diabetics (114.2 +/- 1.8 and 60.1 +/- 1.2 mm Hg, p < 0.05) or control subjects (113.3 +/- 1.2 and 60.1 +/- 1.2 mm Hg, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Lurbe
A
A
Northwestern University Medical School, Chicago, IL 60611.
Redón
J
J
Pascual
J M
JM
Tacons
J
J
Alvarez
V
V
Batlle
D C
DC
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000209:etiology; D001794:Blood Pressure; D002648:Child; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D012890:Sleep / Q000502:physiology*