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Sleep-time BP: prognostic marker of type 2 diabetes and therapeutic target for prevention.
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- Author(s): Hermida RC;Hermida RC; Ayala DE; Ayala DE; Mojón A; Mojón A; Fernández JR; Fernández JR
- Source:
Diabetologia [Diabetologia] 2016 Feb; Vol. 59 (2), pp. 244-54. Date of Electronic Publication: 2015 Sep 23.- Publication Type:
Journal Article; Research Support, Non-U.S. Gov't- Language:
English - Source:
- 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)
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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
- Source:
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