title: Blood pressure variability and its association with echocardiographic parameters in hypertensive diabetic patients.
abstract: BACKGROUND
  Blood pressure (BP) variability is associated with target organ damage in hypertension and diabetes. The 24 h ambulatory blood pressure monitoring (24 h-ABPM) has been proposed as an evaluation for BP variability using several indexes [standard deviation (SD) of mean BP, coefficient of variation (CV), BP variation over time (time-rate index)].
  
  
  METHODS
  We evaluated the association between BP variability measured by 24 h-ABPM indexes and echocardiographic variables in a cross-sectional study in 305 diabetic-hypertensive patients.
  
  
  RESULTS
  Two groups were defined by the median (0.55 mmHg/min) of time-rate systolic BP (SBP) index and classified as low or high variability. Age was 57.3 ± 6.2 years, 196 (64.3%) were female. Diabetes duration was 10.0 (5.0-16.2) years, HbA1c was 8.2 ± 1.9%. Baseline clinical characteristics were similar between low (n = 148) and high (n = 157) variability groups. Office SBP and systolic 24 h-ABPM were higher in the high variability group (139.9 mmHg vs 146.0 mmHg, P = 0.006; 128.3 mmHg vs 132.9 mmHg, P = 0.019, respectively). Time-rate index, SD and CV of SBP, were higher in high variability group (P < 0.001; P < 0.001 and P = 0.003, respectively). Time-rate index was not independently associated with the echocardiography's variables in multiple linear model when adjusting for age, 24 h-ABPM, diabetes duration and HbA1c. The multiple linear regression model revealed that the significant and independent determinants for septum thickness, relative wall thickness and posterior wall thickness (parameters of left ventricular hypertrophy) were: age (p = 0.025; p = 0.010; p = 0.032, respectively) and 24 h-SBP (p < 0.001 in the three parameters).
  
  
  CONCLUSIONS
  BP variability estimated by 24 h-ABPM is not independently associated with echocardiographic parameters in diabetic-hypertensive patients.
authors.affiliation: Cardiology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. dmassierer@gmail.com.|Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, Porto Alegre, RS, Brazil. dmassierer@gmail.com.
authors.forename: Daniela
authors.initials: D
authors.lastname: Massierer
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. ly.ley@hotmail.com.|Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, Porto Alegre, RS, Brazil. ly.ley@hotmail.com.
authors.forename: Liana Farias
authors.initials: LF
authors.lastname: Leiria
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. mateusdsevero@gmail.com.
authors.forename: Mateus Dorneles
authors.initials: MD
authors.lastname: Severo
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. pri_ledur@hotmail.com.
authors.forename: Priscila Dos Santos
authors.initials: Pdos S
authors.lastname: Ledur
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. alexandre.dbecker@gmail.com.|Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil. alexandre.dbecker@gmail.com.
authors.forename: Alexandre Dalpiaz
authors.initials: AD
authors.lastname: Becker
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil. femusaguiar@gmail.com.
authors.forename: Fernanda Mus
authors.initials: FM
authors.lastname: Aguiar
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. eliandra_lima@hotmail.com.|Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil. eliandra_lima@hotmail.com.
authors.forename: Eliandra
authors.initials: E
authors.lastname: Lima
authors.affiliation: Cardiology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. valeriacfreitas@globo.com.
authors.forename: Valéria Centeno
authors.initials: VC
authors.lastname: Freitas
authors.affiliation: Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. beatrizschaan@gmail.com.|Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil. beatrizschaan@gmail.com.
authors.forename: Beatriz D
authors.initials: BD
authors.lastname: Schaan
authors.affiliation: Cardiology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, sala 2061, 90035-003, Porto Alegre, RS, Brazil. mgus@terra.com.br.|Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, Porto Alegre, RS, Brazil. mgus@terra.com.br.
authors.forename: Miguel
authors.initials: M
authors.lastname: Gus
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013318:Stroke Volume / Q000502:physiology