TY - JOUR
T1 - Circadian rhythm of arterial blood pressure and albuminuria in diabetic nephropathy
AU - Hansen, Henrik P.
AU - Rossing, Peter
AU - Tarnow, Lise
AU - Nielsen, Flemming S.
AU - Jensen, Berit R.
AU - Parving, Hans Henrik
PY - 1996/1/1
Y1 - 1996/1/1
N2 - The aim of our study was to evaluate the diurnal relationship between arterial blood pressure and albuminuria, and some potential mechanisms responsible for impaired nocturnal blood pressure reduction (non-dippers, groups I and II) in diabetic nephropathy (DN). Twenty-four-hour ambulatory blood pressure, heart rate (HR) variation (autonomic nervous function) and extracellular fluid volume (ECV) were measured, and urine samples were collected three times during the corresponding day- and nighttimes in 47 insulin-dependent diabetic (IDDM) patients with DN. Mean arterial blood pressure (MABP) during the daytime [mm Hg, median (range)] was identical in group I [105 196-137)], group II [109 186-124)] and group III [dippers; average blood pressure reduction from day to night > 10%, 107 (93-132), P = NS], while the nighttime MABP differed [group I, 106 (95-144); group II, 100 (78-118); group III, 91 (76-118); P < 0.001]. No significant difference between the groups concerning the daytime or nighttime albuminuria [μg/min; median (range)] was observed; [Day: group I, 1467 (235-3933); group II, 695 (170-6719); group III, 875 (228-3173). Night: group I, 1079 (279-4665); group II, 572 (113-3807); group III, 659 (81-2493)]. A significant correlation between MABP and albuminuria was demonstrated during day- (p= 0.50, P < 0.0005) and nighttime (p = 0.46, P < 0.005), while neither the absolute nor the relative changes in MABP from day to night correlated significantly with absolute or relative changes in albuminuria from day to night. The night/day ratio of HR was higher in group l [0.93 (0.76-1.09), median (range)] compared to group III [0.83 (0.741.02), P < 0.005] and a significant correlation between this ratio and the night/day ratio of MABP was found (p =0.54, P < 0.0005). ECV was about the same in the three groups. Our study indicated an association between blood pressure and albuminuria, but the mechanisms involved in the reduction of albuminuria from day to night was not unraveled. A relative lack of sympathetic withdrawal during sleep seems to the an important feature of nocturnal hypertension in diabetic nephropathy.
AB - The aim of our study was to evaluate the diurnal relationship between arterial blood pressure and albuminuria, and some potential mechanisms responsible for impaired nocturnal blood pressure reduction (non-dippers, groups I and II) in diabetic nephropathy (DN). Twenty-four-hour ambulatory blood pressure, heart rate (HR) variation (autonomic nervous function) and extracellular fluid volume (ECV) were measured, and urine samples were collected three times during the corresponding day- and nighttimes in 47 insulin-dependent diabetic (IDDM) patients with DN. Mean arterial blood pressure (MABP) during the daytime [mm Hg, median (range)] was identical in group I [105 196-137)], group II [109 186-124)] and group III [dippers; average blood pressure reduction from day to night > 10%, 107 (93-132), P = NS], while the nighttime MABP differed [group I, 106 (95-144); group II, 100 (78-118); group III, 91 (76-118); P < 0.001]. No significant difference between the groups concerning the daytime or nighttime albuminuria [μg/min; median (range)] was observed; [Day: group I, 1467 (235-3933); group II, 695 (170-6719); group III, 875 (228-3173). Night: group I, 1079 (279-4665); group II, 572 (113-3807); group III, 659 (81-2493)]. A significant correlation between MABP and albuminuria was demonstrated during day- (p= 0.50, P < 0.0005) and nighttime (p = 0.46, P < 0.005), while neither the absolute nor the relative changes in MABP from day to night correlated significantly with absolute or relative changes in albuminuria from day to night. The night/day ratio of HR was higher in group l [0.93 (0.76-1.09), median (range)] compared to group III [0.83 (0.741.02), P < 0.005] and a significant correlation between this ratio and the night/day ratio of MABP was found (p =0.54, P < 0.0005). ECV was about the same in the three groups. Our study indicated an association between blood pressure and albuminuria, but the mechanisms involved in the reduction of albuminuria from day to night was not unraveled. A relative lack of sympathetic withdrawal during sleep seems to the an important feature of nocturnal hypertension in diabetic nephropathy.
UR - http://www.scopus.com/inward/record.url?scp=0029813206&partnerID=8YFLogxK
U2 - 10.1038/ki.1996.352
DO - 10.1038/ki.1996.352
M3 - Article
C2 - 8840289
AN - SCOPUS:0029813206
SN - 0085-2538
VL - 50
SP - 579
EP - 585
JO - Kidney International
JF - Kidney International
IS - 2
ER -