Circadian blood pressure variation and antihypertensive medication adjustment in normoalbuminuric type 2 diabetes patients.
OBJECTIVE
The aim of the study was to assess the effect of an antihypertensive treatment adjustment on 24-hour blood pressure variation in type 2 diabetes patients.


METHODS
The study group included 59 hypertensive type 2 diabetes patients subjected to a single one-step antihypertensive agent dose adjustment (increase or decrease). Ambulatory blood pressure monitoring was performed at baseline and 4-6 weeks after the treatment modification. Controls were 41 matched patients, in whom antihypertensive treatment remained unchanged.


RESULTS
At baseline, 45 (76%) study group patients and 29 (71%) controls were 'non-dippers'; a similar number of patients in both groups converted to 'dipping' or vice versa: 11 (19%) from the study group and 7 (17%) controls. 'Converters' from the study group were significantly younger (47.5 +/- 3.9 vs. 56.4 +/- 12.2 years; p < 0.05) and had lower 24-hour systolic blood pressure than 'non-converters': 113.7 +/- 7.2 vs. 127.7 +/- 20.3 mm Hg (p < 0.01).


CONCLUSIONS
A single one-step antihypertensive medication adjustment does not affect 'dipping' status in type 2 diabetes patients. However, the assessment of blood pressure variation should be made with greater caution in younger type 2 diabetes subjects with low systolic blood pressure.
Czupryniak
Leszek
L
Diabetology and Metabolic Diseases Department, Medical University of Lodz, Barlicki University Hospital No 1, Lodz, Poland. bigosik@poczta.onet.pl
Pawłowski
Maciej
M
Saryusz-Wolska
Małgorzata
M
Loba
Jerzy
J
D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017298:Bisoprolol / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007190:Indapamide / Q000627:therapeutic use; D007211:Indoles / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000627:therapeutic use; D020913:Perindopril / Q000627:therapeutic use; D013148:Spironolactone / Q000627:therapeutic use
D000959:Antihypertensive Agents; D007211:Indoles; D017311:Amlodipine; C052035:trandolapril; D013148:Spironolactone; D009568:Nitrendipine; D007190:Indapamide; D017298:Bisoprolol; D020913:Perindopril