Mayaudon H, Dupuy O, Belmejdoub G, Bredin C, Rivetta F, Avaro J F, Bauduceau B
Service d'endocrinologie, hôpital d'instruction des armées Bégin, Saint-Mandé.
Arch Mal Coeur Vaiss. 2000 Aug;93(8):1029-32.
The aim of this study was to analyse over a four years period the blood pressure rise according to the type of diabetes. The study population was composed of 79 diabetic patients (type 1: 36; type 2: 43). An evaluation of diabetes mellitus is undertaken at a four years interval (A0, A4). In the same time, blood pressure level is assessed using clinic BP and 24 h-ambulatory blood pressure monitoring (ABPM). Type 2 diabetic patients were older than type 1 (60.9 +/- 9.5 vs 43.5 +/- 12.5 years, p < 0.001). The two groups did not differ in body mass index, tobacco consumption, diabetes duration, glycemic control and serum creatinine. Hypertension was more frequent in type 2 diabetes (46.5 vs 11.1%, p < 0.01) and baseline systolic but not diastolic casual BP was significantly higher in type 2 diabetes compared with type 1 (142 +/- 14 vs 132 +/- 15 mmHg, p < 0.01). Between A0 and A4 the increase in type 1 and type 2 diabetics casual BP was not significant. Type 1 diabetic patients 24 h-ABPM did not differ from significant manner at A0 and at A4. Type 2 diabetic subjects had an increase in 24 h and night time SBP (24 h: 123 +/- 14 at A0 vs 130 +/- 16 mmHg at A4, p < 0.05; night time: 116 +/- 15 at A0 vs 125 +/- 17 mmHg at A4, p < 0.02). This reduction in nocturnal BP fall was not associated with an increase in diabetes complications frequency. BP evolution seems to be closely linked to the type of diabetes and to patients age. In this study, frequency of diabetes complications does not increase when BP level is lower than references values for ABPM.
本研究的目的是在四年期间，根据糖尿病类型分析血压升高情况。研究人群由79名糖尿病患者组成（1型：36例；2型：43例）。每四年进行一次糖尿病评估（A0、A4）。同时，使用诊所血压和24小时动态血压监测（ABPM）评估血压水平。2型糖尿病患者比1型糖尿病患者年龄更大（60.9±9.5岁对43.5±12.5岁，p<0.001）。两组在体重指数、吸烟、糖尿病病程、血糖控制和血清肌酐方面无差异。高血压在2型糖尿病中更常见（46.5%对11.1%，p<0.01），与1型糖尿病相比，2型糖尿病的基线收缩压而非舒张压明显更高（142±14对132±15mmHg，p<0.01）。在A0和A4之间，1型和2型糖尿病患者的随机血压升高不显著。1型糖尿病患者的24小时ABPM在A0和A4时无显著差异。2型糖尿病患者的24小时和夜间收缩压有所升高（24小时：A0时为123±14，A4时为130±16mmHg，p<0.05；夜间：A0时为116±15，A4时为125±17mmHg，p<0.02）。夜间血压下降的减少与糖尿病并发症频率的增加无关。血压变化似乎与糖尿病类型和患者年龄密切相关。在本研究中，当血压水平低于ABPM的参考值时，糖尿病并发症的频率不会增加。
