Masked nocturnal hypertension--a novel marker of risk in type 2 diabetes.
OBJECTIVE
This study was designed to evaluate the prevalence of masked nocturnal hypertension (MNHT) and its impact on arterial stiffness and central blood pressure in patients with type 2 diabetes.


METHODS
Middle-aged patients (n = 414) with type 2 diabetes underwent clinic and ambulatory BP measurements and applanation tonometry.


RESULTS
MNHT (clinic BP < 130/80 mmHg and night-time BP > or = 120/70 mmHg) was found in 7.2% of patients (n = 30). Compared with patients with both clinical and nocturnal normotension (n = 70), patients with MNHT had higher aortic pulse wave velocity (PWV) (10.2 +/- 1.8 m/s vs 9.4 +/- 1.7 m/s; p = 0.03) and higher central BP (117.6 +/- 13.9/74.0 +/- 9.1 mmHg vs 110.4 +/- 16.4/69.7 +/- 9.6 mmHg, p = 0.04). In patients with clinical normotension, night-time systolic BP correlated significantly with PWV.


CONCLUSIONS
Thirty per cent of patients with clinical normotension had nocturnal hypertension. This was accompanied by increased arterial stiffness and higher central BP. We conclude that in clinically normotensive patients with type 2 diabetes, ambulatory BP measurement may help clinicians to identify patients with increased cardiovascular risk.
Wijkman
M
M
Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. magnus.wijkman@liu.se
Länne
T
T
Engvall
J
J
Lindström
T
T
Ostgren
C J
CJ
Nystrom
F H
FH
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001011:Aorta / Q000503:physiopathology; D015415:Biomarkers; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D012307:Risk Factors
D000959:Antihypertensive Agents; D015415:Biomarkers