Nocturnal hypertension: Will control of nighttime blood pressure prevent progression of diabetic renal disease?

Moorthi, K; Hogan, Donn; Lurbe, Empar; Redón, Josep; Batlle, Daniel

doi:10.1007/s11906-004-0059-8

Cited by 8 publications

(5 citation statements)

References 45 publications

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“…In a previous study of only 16 hospitalised patients with type 2 diabetes, abnormal circadian rhythms were reported to develop at an early stage of nephropathy. 18 In patients with type 1 diabetes it has been noted that an increase in nocturnal SBP precedes the development of microalbuminuria, 19,20 and that patients with a normal nocturnal dip in BP have a 70% lower risk of developing microalbuminuria.…”

Section: Discussionmentioning

confidence: 94%

“…In addition microalbuminuria was diagnosed on the basis of a one-off clinic urine sample taken within six months of the ABPM being performed and those patients who were already microalbuminuric were excluded. Despite debate in the literature regarding non-dipping of nocturnal BP and the development of microalbuminuria, and whether treatment of nocturnal hypertension would prevent the occurrence of microalbuminuria, 16 we are still no nearer to determining which is cause and which-effect. In order to investigate this question in more detail, a prospective trial of all new patients would avoid some of these confounding factors that proved to be problematic in this study.…”

Section: Discussionmentioning

confidence: 99%

“…This value represents an arbitrary definition but is in keeping with the literature and fits with the observation that the normal reduction in BP through the night is between 10% and 30%. 16 Microalbuminuria was defined as an ACR > 2.5 mg/mmol in males and > 3.5 mg/mmol in females. 17 In 104 subjects there was no evidence of microalbuminuria, 67 of these were dippers and Is non-dipping of nocturnal blood pressure in type 2 diabetes associated with increased incidence of microalbuminuria?…”

Section: Methodsmentioning

confidence: 99%

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Is non-dipping of nocturnal blood pressure in type 2 diabetes associated with increased incidence of microalbuminuria?

Heggie

Adamson

Marioni

et al. 2008

Diabetes & Vascular Disease

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M icroalbuminuria has been associated with non-dipping of nocturnal blood pressure (BP) in people with type 2 diabetes, but the mechanism of this association is unclear. We aimed to identify the development of microalbuminuria in patients with nocturnal non-dipping of BP and type 2 diabetes. Data were examined from 150 people with type 2 diabetes who had undergone ambulatory BP monitoring, non-dippers were defined as those with a systolic nocturnal BP dip less than 10% of the daytime BP.The development of microalbuminuria, over five years of follow-up, in dippers and non-dippers was not significantly different. Non-dippers who were microalbuminuric at baseline were more likely to have a higher body mass index (p=0.01) and to be male (p<0.01).This lack of a difference may be due to the initial exclusion of microalbuminuric patients, who may be genetically predetermined to develop microalbuminuria. Further prospective trials are required to investigate this relationship. Br J Diabetes Vasc Dis 2008;8:136-9

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Is non-dipping of nocturnal blood pressure in type 2 diabetes associated with increased incidence of microalbuminuria?

Heggie

Adamson

Marioni

et al. 2008

Diabetes & Vascular Disease

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“…This is accompanied by increased messenger ribonucleic acid (mRNA) levels of extracellular matrix proteins, such as fibronectin and collagen IV [6]. Nevertheless, other factors have been also implicated [7], such as an elevated pressure load on the arterial glomerular system and an increased glomerular filtration rate (GFR), commonly referred as hyperfiltration [8], which can be present during the initial steps of DN. Furthermore, to our knowledge, few data are available that link oxidative stress to DN development.…”

Section: Introductionmentioning

confidence: 99%

Oxidant/antioxidant status and hyperfiltration in young patients with type 1 diabetes mellitus

et al. 2009

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Diabetic nephropathy (DN), a major cause of morbidity and mortality in diabetes, will develop within a subset of type 1 diabetes mellitus (T1DM) patients, and oxidative stress has been implicated in its pathogenesis. To investigate the relationship between indicators of early DN stages (hyperfiltration estimated by creatinine clearance > or =150 ml/min per 1.73 m(2), microalbuminuria) and oxidative stress, a prospective study was conducted in 29 T1DM patients (age 13.89 +/- 4.61 years) and 18 control subjects (age 13.23 +/- 3.99 years). Blood samples were collected to assay for biomarkers of oxidative stress (malondialdehyde and carbonyl groups) and antioxidants (glutathione peroxidase, reduced glutathione, alpha-tocopherol, and beta-carotene). With respect to control subjects, in T1DM patients, an increase was found in biomarkers of oxidative stress (p < 0.05), mainly due to the group of subjects with hyperfiltration, and a decrease in the ratio alpha-tocopherol/lipids (p < 0.05). In multiple regression analyses, age at disease onset, glycated hemoglobin, microalbuminuria, and oxidative stress biomarkers remained as explicative variables of hyperfiltration (R (2) adjusted = 0.731, p = 0.000). These findings support the importance of the oxidative damage to lipids and proteins, which is linked to hyperfiltration and which could contribute to the development of DN in patients with T1DM.

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“…Research has demonstrated that a lack of nocturnal MAP dipping is a risk factor for cardiovascular events ( 35 ). Moreover, increased nighttime BP was shown to predict the occurrence of microalbuminuria in children with diabetes ( 36 ). Bayrakci et al demonstrated a reverse correlation between high nighttime z-scores for SBP and birth weight in a group of children aged 5 - 17 years ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Profile in the 7th and 11th Year of Life in Children Born Prematurely

et al. 2016

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BackgroundSeveral research trials have analyzed the impact of prematurity on the prevalence of hypertension (HT). However, prospective long-term studies are lacking.ObjectivesThe aim of this study was to evaluate the prevalence of HT at the age of 7 and 11 years in a regional cohort of preterm infants with a birth weight of ≤ 1000 g.Patients and MethodsThis study included 67 children with a birth weight of ≤ 1000 g who were born in Malopolska between September 2002 and August 2004. The control group consisted of 38 children born at term, matched for age. Each child underwent 24-h ambulatory blood pressure measurement (ABPM) twice, once at the age of 7 and again at 11 years. The presence of HT was estimated according to the mean arterial pressure (MAP) and a number of individual measurements.ResultsAt aged 7 years, preterm infants had a significantly higher incidence of HT, defined on the basis of MAP (15% vs. 0%; P < 0.02) and on the percent of individual measurements (56% vs. 33%, P < 0.036). After taking into account the group of patients who received anti-HT treatment after the first part of the study, the incidence of HT at the age of 11 years based on MAP was 19% vs. 10%. Based on the individual measurements, it was 36.5% in the preterm infants vs. 24% in the control group. The differences were not statistically significant. At both time points, the preterm group had a higher mean heart rate (HR) than the control group.ConclusionsChildren born prematurely are predisposed to HT in later life, in addition to the persistence of an increased HR.

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Nocturnal hypertension: Will control of nighttime blood pressure prevent progression of diabetic renal disease?

Cited by 8 publications

References 45 publications

Is non-dipping of nocturnal blood pressure in type 2 diabetes associated with increased incidence of microalbuminuria?

Is non-dipping of nocturnal blood pressure in type 2 diabetes associated with increased incidence of microalbuminuria?

Oxidant/antioxidant status and hyperfiltration in young patients with type 1 diabetes mellitus

Blood Pressure Profile in the 7th and 11th Year of Life in Children Born Prematurely

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