title: Autonomic dysfunction and circadian blood pressure variations in people with impaired glucose tolerance.
abstract: OBJECTIVE
  To assess circadian blood pressure variability in people with impaired glucose tolerance and a healthy control population.
  
  
  METHODS
  Seventy-five people with impaired glucose tolerance and 40 healthy volunteers (frequency matched on 10-year age bands and sex) underwent a detailed neurological assessment. Autonomic neuropathy was detected by the five standard cardiovascular autonomic tests and heart rate variability was characterized by the triangle index. Diurnal indices were assessed by 24-h ambulatory blood pressure monitoring. Systolic and diastolic diurnal indices were defined as: (mean daytime blood pressure - mean night-time blood pressure) × 100/mean daytime blood pressure.
  
  
  RESULTS
  Mean 24-h systolic and diastolic blood pressure was significantly higher in the group with impaired glucose tolerance compared with the control group [126 ± 12 (mean ± SD) vs. 117 ± 10, 75 ± 7 vs. 71 ± 6 mmHg, both P < 0.05). Systolic and diastolic diurnal indices and heart rate variability triangular index were significantly lower in people with impaired glucose tolerance compared with control subjects (9.1 ± 7.8 vs. 13.2 ± 5.4, 14.5 ± 9.7 vs. 18.4 ± 7.1 mmHg, 28.0 ± 8.4 vs. 39.5 ± 9.3, all P < 0.05). Differences in mean diastolic blood pressure, heart rate variability triangular index and the frequency of non-dippers between those with impaired glucose tolerance and control subjects seemed to be independent of BMI and the presence of cardiovascular autonomic neuropathy, as simultaneous adjustment for BMI and cardiovascular autonomic neuropathy had no major effect on the results.
  
  
  CONCLUSIONS
  Our data suggest that people with impaired glucose tolerance have increased diastolic blood pressure and abnormal circadian blood pressure regulation, independent of obesity and the presence of cardiovascular autonomic neuropathy.
authors.affiliation: 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary. putz.zsuzsanna@med.semmelweis-univ.hu
authors.forename: Z
authors.initials: Z
authors.lastname: Putz
authors.forename: N
authors.initials: N
authors.lastname: Németh
authors.forename: I
authors.initials: I
authors.lastname: Istenes
authors.forename: T
authors.initials: T
authors.lastname: Martos
authors.forename: R A
authors.initials: RA
authors.lastname: Gandhi
authors.forename: A E
authors.initials: AE
authors.lastname: Körei
authors.forename: Z
authors.initials: Z
authors.lastname: Hermányi
authors.forename: M
authors.initials: M
authors.lastname: Szathmári
authors.forename: G
authors.initials: G
authors.lastname: Jermendy
authors.forename: S
authors.initials: S
authors.lastname: Tesfaye
authors.forename: Á G
authors.initials: ÁG
authors.lastname: Tabák
authors.forename: P
authors.initials: P
authors.lastname: Kempler
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin