Rodrigues Ticiana C, Pecis Miriam, Azevedo Mirela J, Gross Jorge L
Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, RS.
Arq Bras Endocrinol Metabol. 2005 Dec;49(6):882-90. doi: 10.1590/s0004-27302005000600005. Epub 2006 Mar 16.
The retinopathy and nephropathy are among the most prevalent and disabling complications associated to microvascular damage in diabetes mellitus. The severity of hyperglycaemia and the presence of arterial systemic hypertension are among the main risk factors for these complications. The ambulatory blood pressure provided a better understanding of patterns of blood pressure in diabetic patients. There is a growing number of evidence relating diabetic patients with abnormal 24 h blood pressure patterns. Even subtle modifications of these patterns, frequently shown by patients diagnosed as normotensives in office blood pressure measurings, may be implicated in an increased risk of microvascular complications. Hyperglycaemia and these abnormal pressure patterns appear to have a synergistic effect on promoting and aggravating diabetic retinopathy. Impairment of the normal retinal autoregulation is one of the implicated physiopathological mechanisms. Probably, ABP may be useful in predicting an increased risk of microvascular complications on diabetic normotensive patients. The objective of this paper is to provide an updated and clinically oriented review in blood pressure homeostasis and diabetes mellitus.
视网膜病变和肾病是糖尿病微血管损伤最常见且致残的并发症。高血糖的严重程度和动脉系统性高血压的存在是这些并发症的主要危险因素。动态血压有助于更好地了解糖尿病患者的血压模式。越来越多的证据表明糖尿病患者存在异常的24小时血压模式。即使这些模式有细微变化，常在诊室血压测量中被诊断为血压正常的患者身上出现，也可能与微血管并发症风险增加有关。高血糖和这些异常血压模式似乎对促进和加重糖尿病视网膜病变有协同作用。正常视网膜自动调节功能受损是其中涉及的生理病理机制之一。或许，动态血压可能有助于预测糖尿病血压正常患者微血管并发症风险增加。本文的目的是提供一篇关于血压稳态与糖尿病的最新且面向临床的综述。
