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Titolo:
Increased sympathetic activity during sleep and nocturnal hypertension in Type 2 diabetic patients with diabetic nephropathy
Autore:
Nielsen, FS; Hansen, HP; Jacobsen, P; Rossing, P; Smidt, UM; Christensen, NJ; Pevet, P; Vivien-Roels, B; Parving, HH;
Indirizzi:
Steno Diabet Ctr, DK-2820 Gentofte, Denmark Steno Diabet Ctr Gentofte Denmark DK-2820 Ctr, DK-2820 Gentofte, Denmark
Titolo Testata:
DIABETIC MEDICINE
fascicolo: 7, volume: 16, anno: 1999,
pagine: 555 - 562
SICI:
0742-3071(199907)16:7<555:ISADSA>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR HYPERTROPHY; ARTERIAL BLOOD-PRESSURE; AUTONOMIC NEUROPATHY; JUVENILE DIABETICS; AMBULANT SUBJECTS; MELATONIN; INSULIN; ALBUMINURIA; MORTALITY; TM-2420;
Keywords:
24-h blood pressure; diabetic nephropathy; extracellular fluid volume; melatonin; sympathetic nervous activity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Nielsen, FS Steno Diabet Ctr, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark Steno Diabet Ctr Niels Steensens Vej 2 Gentofte Denmark DK-2820
Citazione:
F.S. Nielsen et al., "Increased sympathetic activity during sleep and nocturnal hypertension in Type 2 diabetic patients with diabetic nephropathy", DIABET MED, 16(7), 1999, pp. 555-562

Abstract

Aims To elucidate the putative factors involved in the blunted nocturnal blood pressure reduction in hypertensive Type 2 diabetic patients with diabetic nephropathy. Methods Extracellular fluid volume and fluid shift from interstitial to plasma volume (haematocrit), sympathetic nervous activity (plasma noradrenaline and adrenaline) and the internal 'body clock' (serum melatonin) were investigated in 31 hypertensive Type 2 diabetes mellitus (DM) patients with diabetic nephropathy (24 males, age 60 (45-73) years). All variables, except extracellular volume, were measured repeatedly with the patients lying awake in bed from 21:30 to 23:00 h (baseline) and during sleep from 23:00 to 07:00h. Using the median nocturnal blood pressure reduction (8.4%) as a guide, the patients were divided into groups; group 1 with the highest and group2 with the lowest nocturnal blood pressure reduction. Results Haematocrit decreased from baseline to the sleep period in group 1by a mean (95% confidence interval (CI)) of 1.7 (0.3-3.1)%, but it increased by 0.5 (-1.0-1.9)% in group 2, mean difference (95% CI), -2.1 (-4.0 to -0.2)% (P = 0.029). Noradrenaline decreased from baseline to the sleep period, mean (95% CI), by 13.3 (0.0-25.0)% in group 1 but rose by 7.7 (-9.7-28.4)% in group 2, mean difference (95% CI), -19.6 (-35-0.0)% (P = 0.049). The nocturnal blood pressure change correlated to the nocturnal change in both noradrenaline (r = 0.51, P = 0.004) and haematocrit (r = 0.42, P = 0.018). Adrenaline remained constant in both groups. Extracellular fluid volume andplasma melatonin levels were comparable in the two groups. Conclusion Sustained adrenergic activity during sleep is associated with blunted nocturnal blood pressure reduction in hypertensive Type 2 DM patients with diabetic nephropathy, probably mediated through a lack of peripheralvasodilatation whereas changes in extracellular fluid volume distribution and melatonin secretion have no impact.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 17:04:11