title: Variations in 7-day/24-h circadian pattern of ambulatory blood pressure and heart rate of type 2 diabetes patients.
abstract: OBJECTIVE
  Diabetes has profound consequences on the cardiovascular system leading to cardiovascular morbidity and mortality in diabetic patients. Blood pressure (BP) has a characteristic and reproducible circadian pattern, with high values during the day and low values at night. A 7-day timed analysis of BP through ambulatory blood pressure monitoring has been used not only to diagnose day and night dipping patterns of blood pressure, but also to measure day-to-day variability and the circadian hyper-amplitude-tension, a condition in which excessive circadian BP amplitude precedes the chronic established hypertension. Our objective was to assess the 7-day/24-h circadian pattern of BP and heart rate in diabetic patients, as it could be helpful in the diagnosis and prevention of cardiovascular morbidity.
  
  
  METHODS
  A total of 50 diabetic patients with type 2 diabetes and 50 non-diabetic participants were recruited for the study. General health records were individually maintained, and 7-day/24-h ambulatory blood pressure monitoring using an ambulatory blood pressure monitor was carried out.
  
  
  RESULTS
  The rhythmic parameters of systolic and diastolic BP, heart rate, double amplitude, acrophase and 3-h fractionated hyperbaric index were found to be significantly high in diabetic patients. A total of 12 participants were diagnosed with circadian hyper-amplitude-tension. These data suggest that diabetic patients have certain variations in the circadian pattern of blood pressure and heart rate, which can result in disturbed vascular events, and thus are at greater risk of cardiovascular morbidity.
  
  
  CONCLUSIONS
  Seven-day/24-h monitoring might be useful as an early predictive tool in assessing future cardiovascular risk, guiding treatment and management of these patients.
authors.affiliation: Department of Physiology, King George Medical University Lucknow, India.
authors.forename: Shipra
authors.initials: S
authors.lastname: Bhardwaj
authors.affiliation: Department of Physiology, King George Medical University Lucknow, India.
authors.forename: Narsingh
authors.initials: N
authors.lastname: Verma
authors.affiliation: Department of Physiology, King George Medical University Lucknow, India.
authors.forename: Baby
authors.initials: B
authors.lastname: Anjum
authors.affiliation: Department of Physiology, King George Medical University Lucknow, India.
authors.forename: Kshitij
authors.initials: K
authors.lastname: Bhardwaj
keywords: Circadian hyper-amplitude-tension; Diabetes; Midline-estimating statistic of rhythm