title: Late afternoon blood pressure increase is associated with diabetic retinopathy in normotensive type 2 diabetes mellitus patients.
abstract: 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.
authors.affiliation: 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
authors.forename: Caroline Kaercher
authors.initials: CK
authors.lastname: Kramer
authors.forename: Cristiane Bauermann
authors.initials: CB
authors.lastname: Leitão
authors.forename: Luís Henrique
authors.initials: LH
authors.lastname: Canani
authors.forename: Eliza Dalsasso
authors.initials: ED
authors.lastname: Ricardo
authors.forename: Lana Catani
authors.initials: LC
authors.lastname: Pinto
authors.forename: Fabiana Borba
authors.initials: FB
authors.lastname: Valiatti
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Gross
mesh_terms: 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