G53 Minor decrease of nocturnal blood pressure in type-2 diabetics. Study by 24-h blood pressure monitoring

POSTERS:BloodPressureMeasurement 73A

A\H-APRIL 1997-VOL. 10, NO. 4, PART 2

G53

G54

MINOR DECREA3E

NON-INVASIVE HEMODYNAMfCS

OF NOCTURNAL BLOOD PRSSSURS IN TYPE-2 DIABETICS.STUOY BY 24-h BLOOD PRSSSURE ,G.Di Donato,SS. P.Porto, MONITORING. M.M. Cangelosi C.Fabbri,A.Saponero,F.Leggio.I.N.R.C.A.-Csrdiology D.spartmsnt-Roms-Ita2y. We evalueted the aversge blood pressure(BP)decrease during the night in patients(pte)withtype. 2 diabetss without cerdiovaeculsrdisautonorny. ’fhe study wss conductsd on 30 diabeticnorrnotsnsive pts(msen ege 54i5 end aversge pressure in the 24-h 9+3 nmd.&)withpatholo~, s bsginning 4.221.6 yeers and in a good metabolic compensation;none of them pr.ssentsdsigns of proliferatingreti~pathy.20 normotensive hee2thy pts,corre.latsd in sge snd sex, were the control group.A2l pts undsrwent a 24-h BP monitoring(ABPSS) .ABPStwss csrried out by a Te2c~ da 2420,with 4 ‘nsasurernsnts/h during the we2king(7 am-lopm)end 2 during the night(lOpm-7em). The normel control group showed a significant reduction of the msen nightly BP(-10# mrnfig)versus the group of diahstic pts(-5t3 mmHg);P.0.002.Furthermore,the diabetics showed a differsnt behavior in the circadian variations of the BP.Indeed they showed a dey-night pressurs difference lower than the control group,statisticallysignificantboth the systolic(p=O.OO1)and the disetolic BP(P=O.002) Finslly we cen ssy that the differences between the day-night pressure,ere deoreased in the diabetic pts;the lower reduction of the tensive nightly va2ues carsbe explained with some unbskmce between the sympathetic end vagus tone(activationof the sympathetic system). Key WOrdS:~b~a~W blood pressurs monitoring,

OF WHfTE COAT HYPERTENSIVE. G Pennasale*, A3S Costs, JE k?, J Conwsy and P Sleight, DSSXSof Cardiology, La Sapianza University, Rome, Itafy and University of Oxford, Oxford UK, National Haart fssatitwe, Lendon, UK The aim of this study was the non-invasive hamdynam “c as-em of white coat hypertcmivcs (WCH) end suatsincd bypxtanaks(SH), agesndsexmatched with normotcmiva controls (NC). We shrdicd 27 subjects (12 M, 15 F, age 32f6 ycsrs), squally subdividedin each of the 3 shrdy grusrps %bjecss withdiaessc othar than -tist hypsrtcnsion wcrsnot inchrded patients were deasified ss WCH orSH onthebaais ofsnoffice DBM mndig(aversBs of3 clinic ratings tekm in 3ssperats occasions) sndadaytime ansbrdatory

DBf4 or>90mndIg.NC werssubjects without medicsl records of elsvatcd BP.HsDIodynamic pramtem was obtained, &et 10minutes of supine rest, by tndsed weve [email protected] ef the ascending Aorie(supm-stcmet view). PeakVelocity (W) (cmis), MI&S Oistence (SD)(cm)and MinuteDistance (MO) (m) were calcutatedfnnn theintcmily waightcd man velocity BP wasmeasured dluiugDo@al usingssrarstometic sphysnsomanemctar. Units (PRU) (sMtrwy enita) were mkufetsd psripberel Resiatmce from main BPM4D. Hat

rste (HR) was csfcrdeted from tbc ECG. bypaired t-ternWe obtsinsdthe follewing results (* ** ***NC vs. WCH,000 “00 NC or WCHVS. SH):

Stedstical difwenm-

SBP DBP MBP ER Pv MD SD PRU

~*

NC I:5f13***o.o &–,o**..0 s2f~o***.o. 6@s” 96~12*000 9f2 1323*” 1M3*”

WCH

SH

141fs 825”’= lolf3”” 72?13 sl~ll 7~2 lot2 15f4

154~21 loof9 11S*13 7sflo 74?s sf3 lof2 16&l

diabetes.nornroteneion.

We conclude that bothWCH ad SH hew higher HR end PRU,sndlower PVsnd SD thensesSIRI agensstched NC,sufgesdng ~en, inaeaatd thstthsbam&anu“cheftsrlerk ofasamdal padphe@reaMewe, isdreedypreasnt inwhim@ *rtemion. Keywords: White caas @=SmMoQ ~ ‘=, mdrldstory DIenitoring, pssh@ym‘Ology

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G56

POST1?ASNDIALSYPOTENaION AND RSDUCED NOCTURNAL LACKOF ASSOCIATIONBETWEENNONINVASIVESLCODPRESSURE FALL IN BLOOD P: SEaSUSE VARIABILITY ANDCARDIACHYPERTROPHYIN HYPERTENSION D Taglia, S , D Recchi, A Scuteri, G l:ermano’ ~, P Verdacchia,C Borglonl,A Ciucci,N Sacchi, G Benemio,C ?mgot:ti, M MusI!31o, M Cacti?, festa, V MmiglianO Porcsllatl.Oepl. of Cardiology& Medicine, SilvestrfniHospital, Perugia, University di ?oma “ La Sapienza “ IPoliclinico and CittAdella Pieve Hospital,Italy. Umbel:toI - ROM3 ( Italy ) Blood pressure (BP) variability could exerf detrimental effecta on left ventricular (LV) structure in hypertension. In order to assess To investigate the possible associat-on of the tha effscf of BP variability on LV mass, 1822 untreatsd subjscts change in blooC3pressure (BP) ind.ucefby MealS wtih essential hypertension (50+12 y, men 52%, clinic BP 157/97 and altered c:ir :adian BP variability 1110subjects mmHg) underwent 24-hour non-invasive ambulatory BP monitoring (1 reading/15’) and M-mode echocardkgrsphy. Since the SD of (mean age 48+/-12 yrs) without any ma-or illness and\or cardioactive pharrracologiral treatment syatolic BP (SBP) was positively associated wlh 24-hour SBP (r=0,27), we divkfsd subjecfa ihto quartiles of 24-hour SBP in order undertook a 24h ABPM. they were divialed into three?subgroup!$according tc,the changes in SP 60 to adjust for the confounding eftscf of average BP. Within each min after meal: Group A, subjects with an quartile, subjects wth SD of day (or night) SBP below or above the increase in 5P after meal; (;roupB, subjects with msdian were conskfersd at bw or high day (or night) SBP a pc,stprandial. fall in SBP < 15%; Group C, variability. Subjscts wfih high daytirns SBP variability were older subjc?cts with postprandial fall in SSP > 15% (men: 54 vs 50 y; women: 51 vs 47 y; both wO.01) than those at (postprandialllflotension, PH) with resl>ectto the low variability. LV mass progressively increassd wfih average 24The BP values immediately befcre the meal hour SBP in both sexes (Figure). ;""''"'"lti""""""""'''""""""""""''"""""""""""''`"''"'"""""""""'""""'~ three groups w?re similar with respe!ctto sex Within each quarlile, LV mass did ~= Men distribution, K,revalenceof” hypertension (4o%), notdiffer baiween the groups at i E mean age, glyc,cmia,plasma lipids prH ( Pn with the BP values 114 gin”’ in men at low and high ;~12 ;E immediatelybef>re the mealI r=O.40a, p< O.01 for night SBP variability (p=.31). :Q SBP and r=O.355, p
;

Kay WOrtfS:

h ypsrtension. ambulatory BP nsoniforing. BP variability. left ventricular hypertrophy

DBP changes sh>wed a negative correlation with the :lOcturqalfall in BP (::=-0.469, P
p>atprandial hypotensioP - circadian variabilit:f- 24h blooclpressure monitoring