REDUCED DIURNAL-VARIATION OF BLOOD-PRESSURE IN NON-INSULIN-DEPENDENT DIABETIC-PATIENTS WITH MICROALBUMINURIA

In essential hypertension reduced diurnal blood pressure (BP) variatio n is associated with an increased prevalence of target organ damage. W e have examined diurnal BP variation in 25 microalbuminuric (MA) and 1 9 normoalbuminuric (NMA) patients with non-insulin-dependent diabetes and related albumin excretion rate (AER) to diurnal BP variation in th e microalbuminuric group. There were no significant differences in age , body mass index (BMI), renal function, diabetic control, clinic or d aytime ambulatory BP between the groups. Night-time SEP was higher (MA 145 mm Hg (137-153), NMA 132 mm Hg (125-139); P = 0.019) in the micro albuminuric group while the diurnal variation as assessed by the day-n ight dip in BP was significantly reduced in the microalbuminuric group (systolic: (mean (95% confidence intervals) MA 4.7% (1.7-7.7), NMA 12 .8% (9.5-16.0), p = 0.001; diastolic: MA 6.5% (3.0-10.0), NMA 14.5% (1 0.2-18.8), P = 0.007). Within the microalbuminuric group, the systolic dip in BP was inversely related to the AER (r = -0.48, P = 0.015). Re duced diurnal BP variation and high night-time BP may contribute to ta rget organ damage in diabetes.