American Journal of BioMedicine Volume 2, Issue 9, September 2014
Abdulhamza Rajooj Hmood; Laith Abdulhussein Abbas Aldabbagh; Hassan Salim Abdulsada; Rawaa Hatif Abd; Saeed H. Lafta; khadeejh Rajooj Hmood
Abstract
ABPM is the best method of detecting WCH in diabetic patients. We report ABPM findings in 100 diabetic individuals with WCH during 2 years. All of the referred subjects underwent casual and ambulatory blood pressure measurements. The mean age of participants was 41.43 year (±13.3 SD) and the age range from 19–74 years; majority were male (80%). The proportion of ambulatory-confirmed average 24-hours true hypertension was significantly reduced when the duration of the study was increased to 48 hours (P<0.001). Day-time systole (P=0.036) as well as night-time systole (P=0.001) and diastole (P<0.001) were statistically different during the two period of monitoring. Dipping pattern had increased from 53% to 60% (P=0.02) but non-dipper pattern was a common finding. Blood pressure load had been normalized in 19% of patients when the duration of study increases to 48 hours (P<0.001). WCH was common in T2DM and the best diagnostic tool was 48-hours ABPM. The dominant rhythm was dipper and absence of nocturnal drop was also common. Blood pressure load might be accurately determined with 48-hours ABPM.
Keywords: Ambulatory blood pressure monitor; Blood pressure; White coat hypertension; Type 2 diabetes mellitus
Open Access Full Text-PDF Feedback
References
1. Diabetes, hypertension, and cardiovascular disease: an update. James R. Sowers, Murray Epstein and Edward D. Frohlich. Hypertension 2001;37: 1053-1059. [Abstract/Full-Text]
2. O’Brien E, Parati G, Stergiou G, et al. On behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hyperten 2013; 31:1731–1767. [Abstract]
3. O’Brien E, Coats A, Owens P, Petrie J, Padfield PL, Littler WA, de Swiet M, Mee F. Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British hypertension society. BMJ 2000; 320:1128–1134. [Abstract/Full-Text]
4. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, Jones DW, Kurtz T, Sheps SG, Roccella EJ. Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension 2005; 45:142–161. [Abstract/Full-Text]
5. O'Brien E, Parati G, Stergiou G. Ambulatory Blood Pressure Measurement. What is the international consensus? Hypertension. 2013; (6): 988-94. [PubMed] [Abstract/Full-Text]
6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–1252. [PubMed]
7. O’Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, et al. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens 2005; 23:697–701. [PubMed]
8. O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G, et al. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens 2013; 2013; (9):1731-68. [PubMed]
9. Stenehjem AE, Os I. Reproducibility of blood pressure variability, white-coat effect and dipping pattern in untreated, uncomplicated and newly diagnosed essential hypertension. Blood Press 2004;13:214–224. [PubMed]