VALUE OF AMBULATORY BLOOD-PRESSURE MONITORING IN TYPE-I (INSULIN-DEPENDENT) DIABETIC-PATIENTS WITH INCIPIENT DIABETIC NEPHROPATHY

被引：30

作者：

BERRUT, G

HALLAB, M

BOUHANICK, B

CHAMEAU, AM

MARRE, M

FRESSINAUD, P

机构：

[1] Service de Médecine B, Centre Hospitalier Universitaire, Angers

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1994年 / 7卷 / 03期

关键词：

AMBULATORY BLOOD PRESSURE MONITORING; MICROALBUMINURIA; TYPE I INSULIN-DEPENDENT DIABETES; DIABETIC NEPHROPATHY;

D O I：

10.1093/ajh/7.3.222

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Ambulatory blood pressure monitoring (ABPM) is currently proposed for measuring blood pressure in type I, insulin-dependent diabetic subjects with incipient diabetic nephropathy. However, the value of this method, in comparison with conventional ones in detecting blood pressure differences between normotensive type I, insulin-dependent diabetic subjects with or without microalbuminuria, is questionable. We obtained systolic, diastolic, and mean blood pressures (SBP/DBP/MBP) in 10 hospitalized normotensive type I, insulin-dependent diabetic subjects with microalbuminuria, and in 29 others without, using a mercury sphygmomanometer (method 1) and an automatic device (Dinamap; method 2) to obtain morning (9 to 11 AM) measurements, and ABPM (SpaceLabs 90207; method 3) to obtain daytime (7 AM to 10 PM) and nighttime (10 PM to 7 AM) measurements. During the daytime, SBP/DBP/MBP values were higher in microalbuminuric than in normoalbuminuric patients, whatever the blood pressure measurement method used (P=.034/.061/.033, two-factor ANOVA). Analysis of 24-h ABPM also showed higher SBP/DBP/MBP in microalbuminuric than in normoalbuminuric patients (P=.022/.040/.016), and demonstrated a defect in nocturnal SBP decrease in microalbuminuric compared with normoalbuminuric patients (P=.028). Stepwise multiple regression analysis indicated nocturnal SBP as the only independent factor determining for microalbuminuria (F=6.72). Thus ABPM, in relation to other methods, indicates above all that the most relevant blood pressure change in type I insulin-dependent diabetic subjects with microalbuminuria is a defect in nocturnal SBP decrease.

引用

页码：222 / 227

页数：6

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