Reproducibility of ambulatory blood pressure monitoring in hypertensive patients with type 2 diabetes mellitus.
OBJECTIVE
To evaluate the reproducibility of ambulatory blood pressure monitoring (ABPM) (SpaceLabs-90207) and placebo effect on ABPM.


METHODS
Blood pressure was measured in the office and over two ABPM periods with an interval from one to ten months (mean 4.9 months), in 26 patients with type 2 diabetes mellitus and hypertension. Eleven patients (G1) had two ABPMs without taking antihypertensive drugs for 15 days, whereas G2 (N=15) had the second ABPM after administration of a placebo for 15 days.


RESULTS
In the evaluation of the coefficient of variation (CV) of diurnal (awake) systolic BP (DSBP), of diurnal (awake) diastolic BP (DDBP), of 24-hour systolic BP (24hSBP) and of 24-hour diastolic BP (24hDBP), the values found were 4.6%, 3.9%, 5.0%, 4.0% for G1 and 4.3%, 5.1%, 3.7%, 5.1% for G2 respectively. We also determined the CV of nocturnal (sleep) systolic and diastolic BP (NSBP and NDBP) for G1 (7.7%; 8.2%) and G2 (5.6%; 6.3%). Heart rate CV during alertness and sleep were: G1=5.9% and 9.0%; G2=6.9% and 5.8% respectively. When the total number of 'patients was analyzed, all variables showed a strong correlation between the first and second ABPM measurements (DSBP, r = 0.76; P < 0.001; DDBP, r = 0.65; p < 0.001; 24hSBP, r = 0.77; p < 0.001; 24hDBP, r = 0.70; p < 0.001; NSBP, r = 0.62; p < 0.001; NDBP, r = 0.52; p < 0.01). Office systolic and diastolic BP and 24hSBP and 24hDBP also showed correlation (r = 0.65; p < 0.001; r = 0.57; p < 0.01).


CONCLUSIONS
Mean of pressure levels measured by ABPM presented good reproducibility and were not affected by placebo.
Felício
João Soares
JS
Divisão de Nefrologia e Endocrinologia, UNIFESP, São Paulo, SP, Brazil. felicio.bel@terra.com.br
Pacheco
Juliana Torres
JT
Ferreira
Sandra Roberta
SR
Plavnik
Frida
F
Kohlmann
Oswaldo
O
Ribeiro
Artur Beltrame
AB
Zanella
Maria Tereza
MT
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D015990:Placebo Effect; D015203:Reproducibility of Results; D013997:Time Factors
D000959:Antihypertensive Agents