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Clinical variables associated with non-dipping of nocturnal blood pressure in type 2 diabetes

Metabolic Unit, Western General Hospital, Edinburgh, UK

Lorna Robinson

Metabolic Unit, Western General Hospital, Edinburgh, UK

Paul L Padfield

Metabolic Unit, Western General Hospital, Edinburgh, UK

Mark WJ Strachan

Metabolic Unit, Western General Hospital, Edinburgh, UK, mark.strachan{at}luht.scot.nhs.uk

Aim

Non-dipping of nocturnal BP (blood pressure) is common in people with type 2 diabetes and is associated with increased risk of cardiovascular morbidity and mortality. This study aimed to identify the factors associated with nocturnal non-dipping of BP in people with type 2 diabetes.

Methods

Data were examined from 100 people with type 2 diabetes who had undergone ambulatory BP monitoring. Dippers were defined as those with a systolic night-time BP dip over 15%, and non-dippers as those with a systolic night-time BP dip of under 5%.

Results

There was no significant difference between the mean awake systolic BP in the dipping (142.9 mmHg) and the non-dipping (142.0 mmHg) groups (p=0.77). Non-dippers were significantly older (p<0.0001) with a higher prevalence of albuminuria (p=0.003) and of macrovascular disease (p=0.008) when compared with the dipping group. After adjustment for age, albuminuria remained more prevalent within the non-dipping group (p=0.007). There was no significant difference in glycaemic control, type of diabetes treatment, smoking status, or gender between the groups.

Conclusion

Albuminuria is strongly associated with non-dipping of nocturnal BP in people with type 2 diabetes.

Key Words: ambulatory blood pressure • dipping • non-dipping type 2 diabetes.

The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 5, 236-240 (2008)
DOI: 10.1177/1474651408096678


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