Analysis of indicators of daily blood pressure profile in patients wi th type 1 diabetes, depending on the course of the disease

Abstract

The aim: to study the features of daily profile and circadian rhythm of blood pressure (BP) in groups of patients with type 1 diabetes mellitus (T1DM), depending on glycemic control. Materials and methods: 63 patients with T1DM, age: 18-45 years without hypertension were examined. Patients were divided into groups: Group 1 — HbA1c≤7.0% (n=21), Group 2 — HbA1c>7.0% (n=42). 10 sex- and agematched healthy controls were included. Results: Patients with T1DM had a significantly higher pulsatile blood pressure (PBP) per night, higher daily systolic blood pressure (SBP) variability, compared with healthy controls, and significantly higher daily SBP area index (SPAI24), daily SBP time index (SPTI24), daily diastolic blood pressure (DBP) area index (DPAI24), daily DBP time index (DPTI24). The double product (DP) was higher in patients with T1DM in the daytime and within 24 hours compared to control (p=0.002) and (p=0.001) respectively. Pathological profiles of daily blood pressure were found. In group 1, according to the dipping in SBP 28.57% of patients were non-dippers, 4.76% were extreme dippers. In group 2, the non-dipper profile had 33.33%, the reverse dipper had 2.38%, and extreme dipper had 11.90% of patients. According to the dipping in DBP: in group 1 33.33% were non-dippers, and 9.53% were extreme dippers. In group 2 non-dippers — 19.04%, extreme dippers — 2.38%, extreme dippers — 38.10%. HbA1c directly correlates with: (DPAI24) (ρ=0,301; р=0,014), DPAI night (ρ=0,292; р=0,010), DPTI24 (ρ=0.292; p=0.012), DPTI night (ρ=0.268; p=0.018). Conclusions. The daily blood pressure profile in patients with T1DM without arterial hypertension is characterized by insufficient decrease in BP at night, an increase in the average daily DBP, PBP, as well as DPAI24, DPTI24, DP and the variability of the average daily SBP. Poor glucose control led to led to an increase in hemodynamic load. It is the risk factor cardiovascular complications in patients with T1DM.