IntroductionThe aim of this study was to evaluate the effect of melatonin on blood pressure in patients with essential hypertension receiving medical treatment and with type 2 diabetes in good metabolic control.Material and methodsThe study lasted 8 weeks. Patients were equipped with a 24-hour ambulatory blood pressure monitor and took melatonin (3 mg a day in the evening) for 4 weeks. The patients were divided into four groups: group 1 (n = 32) including dippers, group 2 (n = 34) non-dippers treated with melatonin; and two control groups: group 3 (n = 28) including dippers and group 4 (n = 30) non-dippers treated without melatonin. After 4 weeks patients took melatonin for the next 4 weeks (5 mg a day). In each visit were analyzed: systolic, diastolic and mean blood pressure in both day and night time.ResultsWe observed that 29.5% non-dippers (n = 10) treated with melatonin in a dose of 3 mg/day achieved features of dippers compared to control group (p < 0.05). Five mg of melatonin per day restored normal diurnal blood pressure rhythm in 32.4% non-dippers (n = 11, p < 0.05). In non-dippers treated with melatonin significant decreases of diastolic, systolic and mean night blood pressure values (p < 0.05) were observed.ConclusionsMore than 30% of non-dippers with type 2 diabetes treated with melatonin were restored to the normal circadian rhythm of blood pressure. The effect of melatonin in both doses (3 mg and 5 mg) was significant for non-dippers only and included nocturnal systolic, diastolic and mean arterial pressure.
There is no doubt that behavioral intervention is crucial for type 2 diabetes mellitus (T2DM) prevention and management. We aimed to estimate dietary habits and diet-oriented knowledge as well as the level of physical activity in 2500 insulin-treated Polish type 2 diabetes mellitus (T2DM) patients (55.4% women). The mean age of the study participants was 64.9 ± 9.3 years, mean BMI was 31.4 kg/m2 ± 4.5, mean diabetes duration was 12.4 ± 6.9 years, and mean baseline HbA1c was 8.5% ± 1.2. At the study onset, all the patients completed a questionnaire concerning health-oriented behavior. Results showed a significant lack of diet-related knowledge. For example, only 37.5% recognized that buckwheat contains carbohydrates; the percentage of correct answers in questions about fruit drinks and pasta was 56.4% and 61.2%, respectively. As for the physical activity, only 57.4% of examined T2DM patients declared any form of deliberate physical activity. To conclude, the cohort of poorly controlled insulin-treated T2DM patients studied by us is characterized by insufficient diet-related knowledge and by a very low level of physical activity. Further studies on other populations of insulin-treated T2DM patients are required to confirm these findings.
ARTYKUŁY ORYGINALNE <140/90 mmHg in all HT patients and to <130/80 mmHg in HT patients with diabetes, as well as in patients at high cardiovascular risk [9]. There are numerous differences between the American guidelines (JNC-7) published in 2003 and current European guidelines. Most of the differences derive from a still better knowledge of the pathophysiology and progress in hypertension treatment over the last four years [10]. Likewise the etiology of "white coat hypertension" (WCH) is not finally explained [11-13]. It is considered that anxiety reactions, as an effect of the presence of medical personnel when measuring blood pressure (BP), play a significant role in the development of that phenomenon [14-16]. Incidence of WCH depends among others on the assumed standards of blood pressure values, a number of ambulatory visits, demographical factors and the patients' age [17-19]. According to analysis performed by Hansen et al. [20] WCH concerns over 10% of the general population. "White coat hypertension" is diagnosed at increased values of blood pressure within medical facilities, while measurements carried out outside such facilities remain within normal limits [17]. According to ESH and ESC guidelines of 2007, the values of blood pressure for clinical measurements should be "White coat hypertension" in type 2 diabetic patients "Nadciśnienie białego fartucha" u chorych na cukrzycę typu 2
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