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High BP at night linked to double risk of death in diabetics

High BP at night linked to double risk of death in diabetics
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New York:  Type 1 or Type 2 diabetes with High BP at night doubled the risk of dying. This compared to those whose blood pressure “dipped” during sleep. A 21-year study on this was presented recently at the AHAHSS 2021.

Blood pressure normally declines, or dips, during sleep. Blood pressure not dropping during the night is non-dipping. If blood pressure increases at night it is “reverse dipping”. Abnormal High BP patterns cause increased risks in adults with Type 1 or Type 2 diabetes.

“Our study shows that 1 in 10 people with type 1 or type 2 diabetes could be a reverse dipper. This condition likely more than doubles the risk of death from any cause over 21 years’ time. Healthcare professionals must look at blood pressure dipping patterns in people with Type 1 or Type 2 diabetes.  Martina Chiriaco, an investigator in experimental medicine at the University of Pisa in Pisa, Italy said about this.

In the study, the researchers also assessed the role of heart rate variability in their study group. Heart rate variability is a measure of the variation in times between each heartbeat.

However, there is still a scarcity of long-term information on the association of reduced heart rate variability with mortality among people with Type 1 or Type 2 diabetes,” Chiriaco said.

Researchers studied 349 adults with diabetes in Pisa, Italy, beginning in 1999. Researchers found more than half of the participants had non-dipping High BP at night linked to double risk of death in diabetics  during the night, and 20 per cent were reverse dippers.

They also found that nearly one-third of reverse dippers had cardiac autonomic neuropathy versus 11 per cent of those who had no dips. Cardiac autonomic neuropathy is a serious complication of diabetes in which the nerves that control the heart and blood vessels are damaged. This nerve damage affects blood pressure and heart rate regulation, increasing the risk of death and cardiovascular events.

Compared to dippers, reverse dippers had an average of 2.5 years reduced survival, and non-dippers had an average of 1.1 years reduced survival.

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