%0 Journal Article
%T Differences in circadian time structure of diastolic blood pressure between diabetes mellitus and essential hypertension
%A Elena Matteucci
%A Luca Della Bartola
%A Ottavio Giampietro
%J Diabetology & Metabolic Syndrome
%D 2012
%I BioMed Central
%R 10.1186/1758-5996-4-51
%X We retrospectively evaluated ambulatory blood pressure monitoring records in 30 NT, 20 T1D, 20 T2D, 20 HT whose fasting plasma glucose and HbA1c were contemporaneously measured. The four groups were well-matched regarding age, gender, and BMI.Systolic blood pressure (SBP) and DBP midline-estimating statistic of rhythm were higher in T1D, T2D, and HT groups. DBP ecphasia was present only in the diabetic individuals: the acrophase of DBP occurred four hours earlier than normal in T1D group, whereas two hours earlier in T2D group. In a multiple regression analysis, only HbA1c and SBP acrophase were statistically significant correlates of DBP acrophase.People with diabetes mellitus, both type 1 and type 2, have their circadian acrophase of DBP occurring 2¨C4 hours earlier than normotensive and hypertensive subjects. Altered circadian timing of DBP, potential trigger of cardiovascular events, seems to be a distinguishing feature of diabetes mellitus and correlates with the previous 2¨C3 months of glycaemic control.Abnormal patterns of circadian blood pressure (BP) variation, evaluated by ambulatory blood pressure monitoring (ABPM), predict cardiovascular prognosis in diabetes mellitus [1]. We have previously described that the acrophase of diastolic blood pressure (DBP), i.e. the time of the maximum of the DBP, registered in type 1 diabetes (T1D) patients occurred significantly earlier than normal and DBP ecphasia (altered circadian timing) was more pronounced in patients with lower heart rate (HR) variability during deep breathing [2]. Several mechanisms could be involved in linking diabetes mellitus with changes in circadian rhythms of BP and HR, such as interactions between metabolism and circadian gene network [3,4], suppressed clock gene oscillations in vasculature [5], or insulin-melatonin antagonism [6]. However, phase shift in acrophase of DBP has never been specifically addressed. The aims of this study were: 1) to compare the circadian rhythm characteristics of B
%K Type 1 diabetes
%K Type 2 diabetes
%K Essential hypertension
%K Ambulatory blood pressure monitoring
%K Circadian rhythm
%U http://www.dmsjournal.com/content/4/1/51