Association Between Glycemic

Control and Morning Blood

Pressure Surge With Vascular
Endothelial Dysfunction in
Type 2
Diabetic Patients
Koichiro Yoda, Masaaki Inaba,
Kae Hamamoto, Maki Yoda,
Akihiro Tsuda,Katsuhito Mori,
Shinsuke Yamada, Masanori Emoto,
Hidenori Koyama, and Yasuo Imanishi
Diabetes Care Volume 37, March
2014

 Patients with DM tend to exhibit

accelerated arteriosclerosis and are
consequently at higher risk of cardiovascular
disease including stroke and coronary heart
disease.
It is possible that inadequate glycemic
control or the occurrence of insulin
resistance activate sympathetic activity,
which leads to MBPS in DM patients.

OBJECTIV
E
evaluate the association :
insulin resistance + glycemic control
with Morning Blood Pressure Surge;
association between:
MBPS and vascular endothelial
dysfunction,
as assessed by
endothelium-dependent FMD and NMD in
T2DM patients.

RESEARCH DESIGN AND

METHODS
50 patients with T2DM;
Exclusion criteria:
renal dysfunction ([eGFR]<60 mL/min/1.73
m2);

type 1 DM;
secondary DM;
prevalent liver disease;
CVD.

RESEARCH DESIGN AND

METHODS

24 h ambulatory blood pressure

monitoring;
Assessed the vascular function by:
brachial arterty flow mediated dilaton
(FMD);
nitroglycerin-mediated dilaton (NMD).

RESULTS

Multivariate Association of the

Clinical Variable With MBPS in T2DM
Patients

Multivariate Association of MBPS With

FMD, but Not NMD in T2DM Patients

CONCLUSIONS
Limitations :
cross -sectional study
insufficient to disentangle potentional
relationships among poor glycemic
control, insulin resistance, and MBPS
(because HbA1c level, HOMA-R, and
MBPS are measured at a single point)

CONCLUSIONS
Limitations:
DM patients enrolled in the study were
treated with various drugs, including
antihypertensive drugs and statins, the
effect of those treatments on MBPS
could not be totally negated

CONCLUSIONS
poor glycemic control and insulin
resistance are independently
associated with the occurrence of
MBPS in T2DM patients, which might
be significantly associated with
endothelial dysfunction.

TAKE HOME MESSAGE

Morning Blood Pressure Surge might

be one of the major targets for
preventing vascular damage in T2DM
patients.

THANK YOU!