Abstract
Blood pressure (BP) was examined using a noninvasive ambulatory BP monitor in 35 patients with non-insulin-dependent diabetes mellitus (NIDDM) and 11 healthy controls. BP recordings were made every 30 minutes for 24 hours. Various tests of autonomic nervous system function were also conducted.
In the controls, average BP during wakefulness was higher than during sleep. Of the 35 diabetic patients, 26 exhibited a diurnal BP variation pattern similar to that of the controls (group A), but in 9 patients, average BP during sleep was higher than during wakefulness (group B). Group B had a longer duration of disease and a higher incidence of somatic neuropathy and retinopathy than did group A.
In the diabetic groups, the magnitude of the difference between average BP during sleep and during wakefulness was significantly related to duration of disease and to the effects of standing and sustained handgrip on the BP. It was also related to the CV% of the R-R interval and to heart rate change in response to the Valsalva maneuver.
The results suggest that both sympathetic and parasympathetic nervous system dysfunction may be involved in changes in the diurnal BP pattern of patients with NIDDM.
