, Volume 52, Issue 7, pp 1258-1264

Masked nocturnal hypertension—a novel marker of risk in type 2 diabetes

Abstract

Aims/hypothesis

This study was designed to evaluate the prevalence of masked nocturnal hypertension (MNHT) and its impact on arterial stiffness and central blood pressure in patients with type 2 diabetes.

Methods

Middle-aged patients (n = 414) with type 2 diabetes underwent clinic and ambulatory BP measurements and applanation tonometry.

Results

MNHT (clinic BP < 130/80 mmHg and night-time BP ≥ 120/70 mmHg) was found in 7.2% of patients (n = 30). Compared with patients with both clinical and nocturnal normotension (n = 70), patients with MNHT had higher aortic pulse wave velocity (PWV) (10.2 ± 1.8 m/s vs 9.4 ± 1.7 m/s; p = 0.03) and higher central BP (117.6 ± 13.9/74.0 ± 9.1 mmHg vs 110.4 ± 16.4/69.7 ± 9.6 mmHg, p = 0.04). In patients with clinical normotension, night-time systolic BP correlated significantly with PWV.

Conclusions/interpretation

Thirty per cent of patients with clinical normotension had nocturnal hypertension. This was accompanied by increased arterial stiffness and higher central BP. We conclude that in clinically normotensive patients with type 2 diabetes, ambulatory BP measurement may help clinicians to identify patients with increased cardiovascular risk.