Late afternoon blood pressure increase is associated with diabetic retinopathy in normotensive type 2 diabetes mellitus patients.
OBJECTIVE
To identify if the variability of blood pressure (BP) is associated with diabetic retinopathy (DR) in normotensive type 2 DM patients.


METHODS
Sixty-five normotensive type 2 DM patients that had 24-h ambulatory BP monitoring (ABPM) were grouped according any degree of DR.


RESULTS
Fourteen (21%) patients had DR. Office BP and 24-h BP parameters did not differ between groups. At late afternoon period, patients with DR had higher increment in both systolic (11.3+/-12.7mmHg vs. 1.0+/-11.4mmHg, P=0.006) and diastolic (6.7+/-8.6mmHg vs. -0.73+/-10.0mmHg, P=0.017) BP levels than those without. Multivariate logistic analyses were performed with DR as a dependent variable. Each 1mmHg increment in systolic BP at the late afternoon period was associated with a 10.2% increase in DR prevalence [OR 1.102 (CI 95% 1.011-1.202, P=0.027)], after adjustments for A1C test, DM duration, age, albuminuria and current smoking.


CONCLUSIONS
In conclusion, in normotensive type 2 DM patients, BP increase at late afternoon is associated to DR independently from confounder factors or other ABPM parameters.
Kramer
Caroline Kaercher
CK
Endocrine Division of Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Prédio 12, 4 degrees andar, 90035-003, Porto Alegre, RS, Brazil. ckkramer@terra.com.br
Leitão
Cristiane Bauermann
CB
Canani
Luís Henrique
LH
Ricardo
Eliza Dalsasso
ED
Pinto
Lana Catani
LC
Valiatti
Fabiana Borba
FB
Gross
Jorge Luiz
JL
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013997:Time Factors