Non Dipper Hypertension And Its Correlated Factors With Type 2 Diabetes

Objective: Non-dipping of nocturnal hypertension is common in people with type 2 diabetes and is associated with increased risk of cardiovascular morbidity and mortality. This study aimed to identify the factors associated with nocturnal non-dipping of HT in people with type 2 diabetes.Methods: Data were obtained from 50 people with type 2 diabetes who had undergone ambulatory BP (blood pressure) monitoring. Dippers were defined as those with a systolic night-time BP dip over 15%. All statistical analyses were performed using SPSS version 11.0 for Windows. Normally distributed data were analysed using a non-paired Students t-test, and non-parametric tests were used for data with a skewed distribution. Chi-squared tests were used for discontinuous variables. The results were adjusted for age using binary logistic regression, using non-dipping status as the dependent variable.Results: No significant differences were seen between the mean day-time systolic BP in the dipping (145.8 mmHg) and the non-dipping (145.0 mmHg) groups (p=0.88). Non-dippers were significantly older (p<0.0001) with a higher prevalence of albuminuria (p=0.003) and of macrovascular disease (p=0.008) when compared with the dipping group. After adjustment for age, albuminuria remained more prevalent within the non-dipping group (p=0.007). There was no significant difference in glycaemic control, type of diabetes treatment, smoking status, or gender between the groups.Conclusion: Albuminuria is strongly associated with non-dipping of nocturnal BP in people with type 2 diabetes. An increase in night-time systolic BP appears to be the earliest detectable manifestation of altered BP regulation in patients with diabetes.