Reprodutibilidade da medida ambulatorial da pressão arterial em pacientes hipertensos com diabete melito tipo 2

Felício, João Soares; Pacheco, Juliana Torres; Ferreira, Sandra Roberta Gouvêa; Plavnik, FL; Kohlmann, Oswaldo; Ribeiro, Artur Beltrame; Zanella, Maria Teresa

doi:10.1590/s0066-782x2007000200012

Cited by 12 publications

(7 citation statements)

References 29 publications

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“…Except in the case of comparing baseline DBP with that at 4 months (71.8%), the concordance in the classification of the dipper pattern between measurements is no higher than 70% and even considering those classified as extreme dippers or risers the pattern may change. Previous publications have reported figures for reproducibility that are similar to those found in our study or slightly lower 29,31,33 . Omboni et al observed a reproducibility of 60.3% considering SBP and 60.9% considering DBP 18 …”

Section: Discussionsupporting

confidence: 90%

“…Previous publications have reported figures for reproducibility that are similar to those found in our study or slightly lower. 29,31,33 Omboni et al observed a reproducibility of 60.3% considering SBP and 60.9% considering DBP. 18 Gorostidi et al 34 and at Booth et al study 35 noted that the nondipper pattern is more common and the reproducibility is slightly higher in high-risk patients than in other groups.…”

Section: Discussionmentioning

confidence: 99%

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Reproducibility study of nocturnal blood pressure dipping in patients with high cardiovascular risk

Burgos-Alonso

Arzalluz

García-Álvarez

et al. 2021

J of Clinical Hypertension

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Ambulatory blood pressure monitoring (ABPM) allows us to measure blood pressure (BP) values and heart rate for periods of 24 and even 48 hours while people go about their normal daily activities. For this reason, this approach is extremely useful for confirming a diagnosis of hypertension, as well as for monitoring the response to antihypertensive treatment. [1][2][3] Values of BP measured using ABPM are more strongly correlated with target organ damage and have greater prognostic value for cardiovascular events than those measured in the consultation room. 4 Further, this type of monitoring provides data on circadian changes in BP, such as decreases during sleep, which are of great importance as prognostic factors. 5 It has been shown that in most people there is a physiological reduction in BP during nighttime sleep, it falling by approximately 10%

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Reproducibility study of nocturnal blood pressure dipping in patients with high cardiovascular risk

Burgos-Alonso

Arzalluz

García-Álvarez

et al. 2021

J of Clinical Hypertension

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“…One of the main problems is the necessity of validation studies of each oscillometric device. We recently tested and retested the Spacelabs - 90207 automatic cuff-oscillometric devices (Spacelabs, Inc. Redmond, WA-USA) in hypertensive type 2 diabetic patients [28] and we found that it is a reliable method to clinical management of those patients. An obstacle that remains is the high price and limited availability of 24-h ABPM devices in general practice.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes

Felício

Souza

Kohlmann

et al. 2010

Cardiovasc Diabetol

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BackgroundHypertensive patients with reduced blood pressure fall (BPF) at night are at higher risk of cardiovascular events (CVE).MethodsWe evaluated in hypertensive diabetic patients, if a reduced nocturnal BPF can precedes the development of diabetic nephropathy (DN). We followed 70 patients with normal urinary albumin excretion (UAE) for two years. We performed 24-hours ambulatory BP monitoring in baseline and at the end of the study.ResultsFourteen (20%) patients (GI) developed DN (N = 11) and/or CVE (n = 4). Compared to the remaining 56 patients (GII) in baseline, GI had similar diurnal systolic (SBP) and diastolic BP (DBP), but higher nocturnal SBP (138 ± 15 vs 129 ± 16 mmHg; p < 0.05) and DBP (83 ± 12 vs 75 ± 11 mmHg; p < 0,05). Basal nocturnal SBP correlated with occurrence of DN and CVE (R = 0.26; P < 0.05) and with UAE at the end of the study (r = 0.3; p < 0.05). Basal BPF (%) correlated with final UAE (r = -0.31; p < 0.05). In patients who developed DN, reductions occurred in nocturnal systolic BPF (12 ± 5 vs 3 ± 6%, p < 0,01) and diastolic BPF (15 ± 8 vs 4 ± 10%, p < 0,01) while no changes were observed in diurnal SBP (153 ± 17 vs 156 ± 16 mmHg, NS) and DBP (91 ± 9 vs 90 ± 7 mmHg, NS). Patients with final UAE < 20 μg/min, had no changes in nocturnal and diurnal BP.ConclusionsOur results suggests that elevations in nocturnal BP precedes DN and increases the risk to develop CVE in hypertensive patients with T2DM.

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“…Recordings with more than three missing hours (maximum of 1 h during the night) were excluded from the analysis. Visit-to-visit BP coefficients of variation are 2–5% (16,17). …”

Section: Methodsmentioning

confidence: 99%

Carotid-Femoral Pulse Wave Velocity Is Associated With Cerebral White Matter Lesions in Type 2 Diabetes

et al. 2013

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OBJECTIVEPatients with type 2 diabetes have a high incidence of cardiovascular events including stroke. Increased arterial stiffness (AS) predicts cardiovascular events in the general population. Cerebral white matter lesions (WMLs) are associated with an increased risk of stroke. It is unknown whether AS in patients with type 2 diabetes is associated with WMLs.RESEARCH DESIGN AND METHODSWe examined 89 patients recently diagnosed with type 2 diabetes (<5 years) and 89 sex- and age-matched controls. AS was assessed with carotid-femoral pulse wave velocity (PWV). WMLs were identified using magnetic resonance imaging and graded qualitatively with the Breteler scale (no/slight changes = 0, moderate changes = 1, severe changes = 2) and semiquantitatively.RESULTSThe diabetic population had excellent glycemic control (HbA1c, 6.5% [6.2–6.8]; median [interquartile range {IQR}]) and had, compared with the controls, lower office blood pressure (BP) (127 ± 12/79 ± 8 vs. 132 ± 14/84 ± 10 mmHg) and total cholesterol (4.3[3.9–4.7] vs. 5.6 [5.1–6.4]; mmol/L; median [IQR]), (P < 0.01 for all). Despite this, PWV was higher in the patients with diabetes compared with controls (9.3 ± 2.0 vs. 8.0 ± 1.6 m/s; P < 0.0001). PWV was associated with Breteler score (OR 1.36 [95% CI 1.17–1.58]; P < 0.001) and WML volume (OR 1.32 [95% CI 1.16–1.51]; P < 0.001) per 1 m/s increase in PWV. These associations remained significant when adjusted for age, sex, diabetes, 24-h mean arterial BP, BMI, heart rate, and use of antihypertensives and statins (Breteler score: OR 1.28 [95% CI 1.03–1.60]; P < 0.05 and WML volume: OR 1.30 [95% CI 1.06–1.58]; P < 0.05).CONCLUSIONSPWV was higher among patients with well-controlled type 2 diabetes compared with controls and was independently associated with WMLs. PWV may represent a clinically relevant parameter in the evaluation of cerebrovascular disease risk in type 2 diabetes.

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Reprodutibilidade da medida ambulatorial da pressão arterial em pacientes hipertensos com diabete melito tipo 2

Abstract: Mean of pressure levels measured by ABPM presented good reproducibility and were not affected by placebo.

Cited by 12 publications

References 29 publications

Reproducibility study of nocturnal blood pressure dipping in patients with high cardiovascular risk

Reproducibility study of nocturnal blood pressure dipping in patients with high cardiovascular risk

Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes

Carotid-Femoral Pulse Wave Velocity Is Associated With Cerebral White Matter Lesions in Type 2 Diabetes

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