%0 Journal Article
%T Ambulatory Blood Pressure Monitoring in Diabetes and Obesity¡ªA Review
%A Kazuo Eguchi
%J International Journal of Hypertension
%D 2011
%I Hindawi Publishing Corporation
%R 10.4061/2011/954757
%X Diabetes mellitus and obesity are both related to the risk of cardiovascular disease and sudden death. In hypertensive guidelines, diabetes and obesity, especially abdominal obesity, are regarded as high-risk factors. Ambulatory blood pressure monitoring (ABPM) is an established method for the management of hypertension. However, ABPM is not a standard tool for the management of hypertension in diabetes and obesity. In this paper, recent data on the use of ABPM in diabetes and obesity will be discussed. In patients with diabetes, the ambulatory BP level has been shown to be better than clinic BP in predicting cardiovascular events. A riser pattern has been associated with increased risk of cardiovascular disease. White-coat hypertension and masked hypertension in diabetics constitute a moderate risk. A nondipping pattern is very common in obese hypertensive patients. In this paper, we will summarize the findings on the use of ABPM in patients with diabetes and obesity. 1. Introduction There have been increasing numbers of diabetic and obese patients in recent years. Hypertension coexisting with diabetes and obesity has a major impact on cardiovascular prognosis. Patients with diabetes and obesity usually have other risk factors, such as dyslipidemia, sleep apnea syndrome, and metabolic syndrome. Strict control of BP has been recommended in these patients. The ACCORD trial proved that aggressive BP control has no such benefit on cardiovascular prognosis in patients with diabetes [1], but a new target level of BP in diabetes has not yet been established in response to these findings. Therefore, individualized control of BP is becoming more important in this post-ACCORD era. In this paper, we summarized the data on ABPM in diabetes and obesity. 2. Ambulatory Blood Pressure Monitoring in Diabetes Diabetes itself is classified as a high-risk factor for cardiovascular disease, and when hypertension coexists with diabetes, not only is the cardiovascular risk magnified, but cardiovascular target organ damages such as silent cerebral infarcts (SCIs) and left ventricular hypertrophy (LVH) may progress. This is why the target level of blood pressure in diabetes is set as low as 130/80£¿mmHg. In a seminal paper by de la Sierra et al. based on findings from 42,947 patients included in the Spanish Society of Hypertension, ABPM registry has shown that diabetes was associated with nondipping status [2]. In clinical practice, it is sometimes very hard to identify the true blood pressure level when the BP variability is very large. In such cases, 24-hour BP monitoring
%U http://www.hindawi.com/journals/ijhy/2011/954757/