Ambulatory blood pressure monitoring in diabetes for the assessment and control of vascular risk
Endocrinol Nutr. 2015 Oct;62(8):400-10.
doi: 10.1016/j.endonu.2015.03.012.
Epub 2015 Sep 26.
[Article in
English,
Spanish]
Affiliations
- 1 Laboratorio de Bioingeniería y Cronobiología, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), Universidad de Vigo, Vigo, España. Electronic address: rhermida@uvigo.es.
- 2 Laboratorio de Bioingeniería y Cronobiología, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), Universidad de Vigo, Vigo, España; Centro de Salud de Lérez, Gerencia Única Integrada Pontevedra-Salnés, Servicio Galego de Saúde (SERGAS), Pontevedra, España.
- 3 Laboratorio de Bioingeniería y Cronobiología, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), Universidad de Vigo, Vigo, España.
Abstract
The diagnosis of hypertension and the clinical decisions regarding its treatment are usually based on daytime clinic blood pressure (BP) measurements. However, the correlation between BP levels and target organ damage, cardiovascular (CV) risk, and long-term prognosis, is higher for ambulatory (ABPM) than clinic measurements, both in the general population as well as in patients with diabetes. Moreover, there is consistent evidence in numerous studies that the asleep BP better predicts CV events than either the awake or 24h means. The prevalence of abnormal BP pattern and sleep-time hypertension is extensive in diabetes, often leading to inaccurate diagnoses of hypertension and its therapeutic control in the absence of complete and careful assessment of the entire 24h, i.e., daytime and night-time, BP pattern. Accordingly, ABPM should be the preferred method to comprehensively assess and decide the optimal clinical management of patients with diabetes directed to properly reduce elevated sleep-time BP, which might also lead to a significant reduction of CV events.
Keywords:
Ambulatory blood pressure monitoring; Asleep blood pressure; Chronotherapy; Cronoterapia; Diabetes; Hipertensión; Hypertension; Monitorización ambulatoria de la presión arterial; Presión arterial nocturna; Riesgo vascular; Vascular risk.
Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Antihypertensive Agents / administration & dosage
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Antihypertensive Agents / therapeutic use
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Blood Pressure Monitoring, Ambulatory*
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Circadian Rhythm / physiology*
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Comorbidity
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Diabetes Mellitus / epidemiology*
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Diabetes Mellitus / physiopathology
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Diagnostic Errors
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Drug Administration Schedule
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Drug Chronotherapy
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Humans
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Hypertension / diagnosis*
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Hypertension / drug therapy
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Hypertension / epidemiology
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Hypertension / physiopathology
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Practice Guidelines as Topic
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Prevalence
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Risk
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Sleep Disorders, Intrinsic / epidemiology
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Sleep Disorders, Intrinsic / physiopathology
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Sleep Stages / physiology