Sleep-time BP: prognostic marker of type 2 diabetes and therapeutic target for prevention.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Springer Verlag Country of Publication: Germany NLM ID: 0006777 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0428 (Electronic) Linking ISSN: 0012186X NLM ISO Abbreviation: Diabetologia Subsets: MEDLINE
    • Publication Information:
      Original Publication: Berlin Springer Verlag
    • Subject Terms:
      Biomarkers*/analysis; Blood Pressure/*physiology ; Diabetes Mellitus, Type 2/*diagnosis ; Diabetes Mellitus, Type 2/*therapy ; Hypertension/*prevention & control; Adult ; Aged ; Blood Pressure Monitoring, Ambulatory ; Circadian Rhythm ; Diabetes Mellitus, Type 2/physiopathology ; Female ; Follow-Up Studies ; Humans ; Hypertension/complications ; Hypertension/diagnosis ; Hypertension/physiopathology ; Male ; Middle Aged ; Prognosis ; Risk Factors
    • Abstract:
      Aims/hypothesis: We investigated the prognostic value of clinic and ambulatory BP (ABP) to predict new-onset diabetes and whether risk reduction is related to the progressive decrease of clinic BP or awake or asleep ABP.
      Methods: We prospectively evaluated 2,656 individuals without diabetes, 1,292 men and 1,364 women, 50.6 ± 14.3 years of age, with baseline BP ranging from normotension to hypertension according to ABP criteria. At baseline and annually (more frequently if hypertension treatment was adjusted based on ABP) thereafter, ABP and physical activity (wrist actigraphy) were simultaneously monitored for 48 h to accurately derive the awake and asleep BP means.
      Results: During a 5.9-year median follow-up, 190 participants developed type 2 diabetes. The asleep systolic ABP mean was the most significant predictor of new-onset diabetes in a Cox proportional-hazard model adjusted for age, waist circumference, glucose, chronic kidney disease (CKD) and hypertension treatment. Daytime clinic BP and awake or 48 h ABP mean had no predictive value when corrected by the asleep ABP mean. Analyses of BP changes during follow-up revealed a 30% reduction in the risk of new-onset diabetes per 1-SD decrease in asleep systolic ABP mean, independent of changes in clinic BP or awake or 48 h ABP means.
      Conclusions/interpretation: Sleep-time BP is a highly significant independent prognostic marker for new-onset diabetes. Alteration in sleep-time BP regulation seems to precede, rather than follow, the development of new-onset diabetes. Most important, lowering asleep BP, a novel therapeutic target requiring ABP evaluation, could be a significant method for reducing new-onset diabetes risk.
    • Comments:
      Comment in: Diabetologia. 2016 Feb;59(2):234-6. (PMID: 26631216)
    • References:
      Chronobiol Int. 2013 Apr;30(3):355-410. (PMID: 23517220)
      Hypertension. 2008 Jun;51(6):1403-19. (PMID: 18391085)
      Diabetes Care. 2013 Jan;36 Suppl 1:S11-66. (PMID: 23264422)
      Chronobiol Int. 2013 Mar;30(1-2):340-52. (PMID: 23077973)
      J Am Coll Cardiol. 2011 Sep 6;58(11):1165-73. (PMID: 21884956)
      Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266. (PMID: 11904577)
      Chronobiol Int. 2013 Mar;30(1-2):280-314. (PMID: 23077971)
      Blood Press Monit. 2010 Aug;15(4):173-80. (PMID: 20571367)
      Hypertension. 2005 Feb;45(2):240-5. (PMID: 15596571)
      Adv Drug Deliv Rev. 2007 Aug 31;59(9-10):904-22. (PMID: 17659807)
      Am J Hypertens. 2007 May;20(5):541-5. (PMID: 17485018)
      Diabetes Care. 2011 Jun;34(6):1270-6. (PMID: 21617110)
      Ann Intern Med. 2009 May 5;150(9):604-12. (PMID: 19414839)
      Chronobiol Int. 2010 Sep;27(8):1629-51. (PMID: 20854139)
      Am J Hypertens. 2012 Mar;25(3):325-34. (PMID: 22158066)
      Chronobiol Int. 2013 Mar;30(1-2):87-98. (PMID: 23039824)
      Chronobiol Int. 2013 Mar;30(1-2):17-30. (PMID: 23002916)
      Diabetes Metab. 2008 Dec;34(6 Pt 1):560-7. (PMID: 18926758)
      Chronobiol Int. 2013 Mar;30(1-2):55-67. (PMID: 23077972)
      Hypertension. 2008 Jan;51(1):55-61. (PMID: 18039980)
      Arch Intern Med. 2011 Jun 27;171(12):1090-8. (PMID: 21709109)
      Circulation. 2003 Mar 18;107(10):1401-6. (PMID: 12642361)
      Chronobiol Int. 2013 Mar;30(1-2):68-86. (PMID: 23181592)
      J Am Soc Nephrol. 2011 Dec;22(12):2313-21. (PMID: 22025630)
      J Hypertens. 2002 Nov;20(11):2183-9. (PMID: 12409956)
      J Hypertens. 2007 Dec;25(12):2479-85. (PMID: 17984670)
      J Hypertens. 2013 Jul;31(7):1281-357. (PMID: 23817082)
      Circulation. 2005 Oct 25;112(17):2735-52. (PMID: 16157765)
      Hypertension. 2007 Jun;49(6):1235-41. (PMID: 17389258)
      J Hum Hypertens. 2014 Oct;28(10):567-74. (PMID: 24500721)
      Am J Hypertens. 2008 Apr;21(4):443-50. (PMID: 18292756)
      Am J Hypertens. 2011 Apr;24(4):383-91. (PMID: 20930708)
      Diabetologia. 2016 Feb;59(2):255-65. (PMID: 26399404)
      Chronobiol Int. 2013 Mar;30(1-2):43-54. (PMID: 23130607)
      Sleep Med Rev. 2012 Apr;16(2):151-66. (PMID: 21641838)
      J Hypertens. 2006 Apr;24(4):647-53. (PMID: 16531792)
      Diabetes. 1998 Sep;47(9):1501-6. (PMID: 9726241)
      Am J Hypertens. 1993 Jan;6(1):1-7. (PMID: 8427656)
      Hypertension. 1994 Dec;24(6):793-801. (PMID: 7995639)
      Blood Press Monit. 2007 Jun;12(3):133-9. (PMID: 17496462)
      Hypertension. 2005 Jul;46(1):156-61. (PMID: 15939805)
      J Hypertens. 2014 Dec;32(12):2332-40; discussion 2340. (PMID: 25333682)
      Chronobiol Int. 2013 Mar;30(1-2):99-115. (PMID: 23098178)
      Diabet Med. 2000 May;17(5):360-4. (PMID: 10872534)
    • Contributed Indexing:
      Keywords: Ambulatory blood pressure; New-onset diabetes; Sleep-time blood pressure
    • Accession Number:
      0 (Biomarkers)
    • Publication Date:
      Date Created: 20150925 Date Completed: 20161019 Latest Revision: 20181113
    • Publication Date:
      20221213
    • Accession Number:
      10.1007/s00125-015-3748-8
    • Accession Number:
      26399403