Endocrine Abstracts

Objectives: To evaluate the prevalence of blood pressure alterations by ABPM and its association with clinical factors in normotensive and normoalbuminuric patients with type 1 diabetes (TDM1).

Methods: Cross-sectional study including normotensive and normoalbuminuric patients with TDM1. Altered ABPM was considered when: i) Mean systolic pressure (sBP) was ≥130 mmHg in the 24 h and daytime periods and ≥120 mmHg in the night-time period and/or mean diastolic pressure (dBP) ≥80 or 70 mmHg in the same periods respectively and/or ii) more than 50% of the readings were higher than the defined previous criteria, and/or iii) nocturnal fall in either sBP or dBP was ≤10% (non-dippers).

Results: 85 patients (55% women), aged 27.9±6.1 years with a disease duration of 12.3±6.5 years. 32% presented mean sBP or dBP altered during daytime period, 32% more than 50% of pathological readings during daytime and 41.6% were non-dippers. Altered ABPM was more prevalent in men. BMI was higher in patients with elevated sBP during daytime (26.4±3.4 vs 23.5±2.7 kg/m², P: 0.002) with significant correlation with 24 h sBP (r: 0.2, P: 0.01) and night-time sBP (r: 0.22, P: 0.04). Non dippers showed worse metabolic control since diagnosis (HbA1c 8.6±1.4 vs 7.9±1.4%, P: 0.04). HDL cholesterol level was lower and triglycerides level higher in subjects with altered sBP or dBP during daytime (HDLc: 55.9±14.4 vs 66.8±13.8 mg/dl, P: 0.03; TG 97.9±52.5 vs 65.7±13.5 mg/dl, P: 0.003). Significant correlation was detected between TG levels and daytime dBP (r:0.2, P: 0.01) and between HDLc and 24 h sBP (r: −0.22, P: 0.003) and night-time sBP (r: −0.22, P: 0.003).

Conclusion: Prevalence of altered ABPM is high in normoalbuminuric and normotensive TDM1. Altered BP was more frequent in men, in patients with elevated BMI, worse metabolic control and lipid profile. ABPM should be performed in patients with TDM1 and cardiovascular risk factors to detect undiagnosed BP alterations and to assess the convenience of treatment.