Diabetes and the Night Pressure

Nocturnal hypertension associated with atherosclerosis in type 1 diabetes patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Diabetes is more than a problem with blood sugar levels. The disease is associated with all sorts of other complications, including high blood pressure - a condition that may lead to even more problems.

Type 1 diabetes patients with nocturnal hypertension (high blood pressure during the night) are more likely to have hardened arteries and a higher daytime blood pressure, compared to those with normal blood pressure.

"Keep track of your blood pressure, inform your doctor of changes."

Sun Hee Lee, M.D., from the Department of Pediatrics at Busan Paik Hospital in South Korea, and colleagues set out to see if nocturnal hypertension had an effect on atherosclerosis (hardening and narrowing of arteries) in children and teens with type 1 diabetes.

Atherosclerosis happens when fat, cholesterol, and other substances build up in the walls of arteries and become hard formations called plaques. Eventually, these plaques can block blood flow through the arteries, leading to problems such as heart attack and stroke.

The method used to diagnose atherosclerosis is called the carotid intima-media thickness test (cIMT). The test measures the thickness of the carotid artery, which can warn doctors of any thickening before patients show any signs of athersclerosis.

The study by Dr. Lee and colleagues showed a higher cIMT and daytime blood pressure in diabetic children and teens with nocturnal hypertension. In other words, patients with a high nighttime blood pressure were more likely to have hardened arteries and a higher daytime blood pressure.

According to the study's authors, this research suggests that ambulatory blood pressure monitoring - which can be used to measure nighttime blood pressure - may be a useful way to spot blood vessel complications in patients with type 1 diabetes.

The researchers came to these conclusions by measuring ambulatory blood pressure and cIMT in 82 children and teens with type 1 diabetes. They also looked at participants' blood sugar levels, signs of kidney damage, heart disease risk, and duration of diabetes.

Of the 82 participants, 52 percent (43 participants) had high blood pressure. About 37 percent (30 participants) had nocturnal hypertension. Those with nocturnal hypertension had thicker carotid arteries than those with normal blood pressure.

While these findings suggest that nocturnal hypertension is linked to hardened arteries, the researchers conclude that more studies are needed to see how a high nighttime blood pressure can lead to hardened and narrow arteries in type 1 diabetes patients.

This observational study by Dr. Lee and colleagues is published in Diabetes Care

Reviewed by: 
Review Date: 
September 14, 2011
Last Updated:
September 15, 2011