title: 24-hour central aortic systolic pressure and 24-hour central pulse pressure are related to diabetic complications in type 1 diabetes - a cross-sectional study.
abstract: BACKGROUND
  Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes.
  
  
  METHODS
  The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (< 10 years), normoalbuminuria (< 30 mg/24 h) without receiving antihypertensive treatment (SN), 211 with longstanding diabetes (≥ 10 years) and normoalbuminuria (LN), 163 with microalbuminuria (30-299 mg/24 h) (Mi) and 186 with macroalbuminuria (> 300 mg/24 h) (Ma).24 h-CASP and 24 h-CPP was measured using a tonometric wrist-watch-like device (BPro, HealthStats, Singapore) and derived using N-point moving average.
  
  
  RESULTS
  In C, SN, LN, Mi and Ma mean ± SD 24 h-CASP was: 114 ± 17, 115 ± 13, 121 ± 13, 119 ± 16 and 121 ± 13 mmHg (p < 0.001); and 24 h-CPP: 38 ± 8, 38 ± 7, 44 ± 10, 46 ± 11 and 46 ± 11 mmHg, (p < 0.001).Following rigorous adjustment (24 h mean arterial pressure and conventional risk factors), 24 h-CASP and 24 h-CPP increased with diabetes, albuminuria degree, previous cardiovascular disease (CVD), retinopathy and autonomic dysfunction (p ≤ 0.031).Odds ratios per 1 standard deviation increase in 24 h-CASP, 24 h-CPP and 24 h systolic blood pressure (24 h-SBP) were for CVD: 3.19 (1.68-6.05), 1.43 (1.01-2.02) and 2.39 (1.32-4.33), retinopathy: 4.41 (2.03-9.57), 1.77 (1.17-2.68) and 3.72 (1.85-7.47) and autonomic dysfunction: 3.25 (1.65-6.41), 1.64 (1.12-2.39) and 2.89 (1.54-5.42).
  
  
  CONCLUSIONS
  24 h-CASP and 24 h-CPP was higher in patients vs. controls and increased with diabetic complications independently of covariates. Furthermore, 24 h-CASP was stronger associated to complications than 24 h-SBP.The prognostic significance of 24 h-CASP and 24 h-CPP needs to be determined in follow-up studies.
  
  
  BACKGROUND
  ClinicalTrials.gov ID NCT01171248.
authors: Steno Diabetes Center, Niels Steensensvej 1, 2820 Gentofte, Denmark. ktld@steno.dk.
authors: Simone
authors: S
authors: Theilade
authors: Maria
authors: M
authors: Lajer
authors: Tine Willum
authors: TW
authors: Hansen
authors: Christel
authors: C
authors: Joergensen
authors: Frederik
authors: F
authors: Persson
authors: Gudbjörg
authors: G
authors: Andrésdottir
authors: Henrik
authors: H
authors: Reinhard
authors: Stine Elkjær
authors: SE
authors: Nielsen
authors: Peter
authors: P
authors: Lacy
authors: Bryan
authors: B
authors: Williams
authors: Peter
authors: P
authors: Rossing
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D062186:Arterial Pressure; D001341:Autonomic Nervous System / Q000503:physiopathology; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013599:Systole; D013997:Time Factors
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