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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Non-dipping and higher nocturnal blood pressure are associated with risk of mortality and development of kidney disease in type 1 diabetes

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AIMS: People with type 1 diabetes have increased risk of cardiovascular (CV) and kidney disease. A 24-hour ambulatory blood pressure (BP) measurement (ABPM) examines diurnal variations in BP. We aimed to determine the prognostic significance of blunted decrease in nocturnal systolic BP of <10 % (non-dipping of nocturnal BP) for CV- and kidney disease and all-cause mortality in type 1 diabetes.

METHODS: From 2009 to 2011, at Steno Diabetes Center Copenhagen, 654 participants with type 1 diabetes had 24-hour ABPM obtained with a tonometric wrist-watch device (BPro, HealthStats, Singapore). In 2017, outcomes (composite CV endpoint; all-cause mortality; decline in estimated glomerular filtration rate (eGFR) ≥30 %; end-stage kidney disease (ESKD); and a composite kidney endpoint including decline in eGFR ≥30 %, ESKD and all-cause mortality) were registered. Hazard Ratios (HR) were calculated using Cox regressions.

RESULTS: Participants were mean ± SD 55 ± 13 years old and had median (IQR) 35 (24-44) years diabetes duration. Mean daytime and nocturnal systolic BP were 133 ± 16 and 121 ± 16 mmHg while 337 (52 %) participants demonstrated non-dipping. After CV risk factor adjustments, non-dipping was associated with all-cause mortality (HR 2.12 (1.09-4.11), p = 0.03) and the composite kidney endpoint (HR 1.92 (1.23-3.00), p = 0.004).

CONCLUSIONS: Non-dipping entailed increased risk of all-cause mortality and kidney disease in type 1 diabetes.

Original languageEnglish
Article number108270
JournalJournal of Diabetes and its Complications
Volume36
Issue number9
Pages (from-to)108270
ISSN1056-8727
DOIs
Publication statusPublished - Sep 2022

Bibliographical note

Copyright © 2022 Elsevier Inc. All rights reserved.

    Research areas

  • Adult, Aged, Blood Pressure/physiology, Blood Pressure Monitoring, Ambulatory, Circadian Rhythm/physiology, Diabetes Mellitus, Type 1/complications, Humans, Hypertension/complications, Kidney Diseases, Kidney Failure, Chronic/complications, Middle Aged, Risk Factors, Kidney disease, Non-dipping, Mortality, Cardiovascular disease, Ambulatory blood pressure, Type 1 diabetes

ID: 84477770