Ambulatory blood pressure monitoring and microalbuminuria in normotensive subjects with insulin-dependent diabetes mellitus.
OBJECTIVE
To assess the association between microalbuminuria with ambulatory blood pressure monitoring in normotensive individuals with insulin-dependent diabetes mellitus.


METHODS
Thirty-seven patients underwent determination of the rate of urinary excretion of albumin through radioimmunoassay and ambulatory blood pressure monitoring. Their mean age was 26.5+/-6.7 years, and the mean duration of their disease was 8 (1-34) years. Microalbuminuria was defined as urinary excretion of albumin > or =20 and <200 microg/min in at least 2 out of 3 urine samples.


RESULTS
Nine (24.3%) patients were microalbuminuric. Ambulatory blood pressure monitoring in the microalbuminuric patients had higher mean pressure values, mainly the systolic pressure, during sleep as compared with that in the normoalbuminuric patients (120.1+/-8.3 vs 110.8+/-7.1 mmHg; p=0.007). The pressure load was higher in the microalbuminuric individuals, mainly the systolic pressure load during wakefulness [6.3 (2.9-45.9) vs. 1.6 (0-16%); p=0.001]. This was the variable that better correlated with the urinary excretion of albumin (r(S)=0.61; p<0.001). Systolic pressure load >50% and diastolic pressure load > 30% during sleep was associated with microalbuminuria (p=0.008). The pressure drop during sleep did not differ between the groups.


CONCLUSIONS
Microalbuminuric normotensive insulin-dependent diabetic patients show greater mean pressure value and pressure load during ambulatory blood pressure monitoring, and these variables correlate with urinary excretion of albumin.
Cohen
C N
CN
Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, RJ, Brazil.
Albanesi
F M
FM
Gonçalves
M F
MF
Gomes
M B
MB
D000328:Adult; D000419:Albuminuria / Q000378:metabolism / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male