Late afternoon blood pressure increase is associated with diabetic retinopathy in normotensive type 2 diabetes mellitus patients

Diabetes Res Clin Pract. 2009 Apr;84(1):e12-4. doi: 10.1016/j.diabres.2008.12.016. Epub 2009 Jan 31.


Aims: To identify if the variability of blood pressure (BP) is associated with diabetic retinopathy (DR) in normotensive type 2 DM patients.

Methods: Sixty-five normotensive type 2 DM patients that had 24-h ambulatory BP monitoring (ABPM) were grouped according any degree of DR.

Results: Fourteen (21%) patients had DR. Office BP and 24-h BP parameters did not differ between groups. At late afternoon period, patients with DR had higher increment in both systolic (11.3+/-12.7mmHg vs. 1.0+/-11.4mmHg, P=0.006) and diastolic (6.7+/-8.6mmHg vs. -0.73+/-10.0mmHg, P=0.017) BP levels than those without. Multivariate logistic analyses were performed with DR as a dependent variable. Each 1mmHg increment in systolic BP at the late afternoon period was associated with a 10.2% increase in DR prevalence [OR 1.102 (CI 95% 1.011-1.202, P=0.027)], after adjustments for A1C test, DM duration, age, albuminuria and current smoking.

Conclusions: In conclusion, in normotensive type 2 DM patients, BP increase at late afternoon is associated to DR independently from confounder factors or other ABPM parameters.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Blood Pressure*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / pathology*
  • Diabetic Retinopathy / complications*
  • Diabetic Retinopathy / pathology*
  • Female
  • Humans
  • Hypertension / etiology*
  • Hypertension / pathology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Time Factors