Purpose of Review This review considers the relationship between abnormal blood pressure (BP) variability and autonomic dysfunction through an attempt to answer questions about its clinical relevance and pertinence to diabetes and cardiovascular autonomic neuropathy (CAN) and which therapeutic measures can lessen its cardiovascular impact. Recent Findings Office, ambulatory, and home BP monitoring identify posture-related, circadian, short-term, and long-term BP variabilities. Abnormal BP variability is a risk marker for organ damage, mortality, and cardiovascular events. Moreover, BP variability changes are common in diabetes and associated with CAN and possibly exacerbated by comorbidities like nephropathy, obstructive sleep apnoea syndrome, and chronic pain. The prognostic role of nondipping and reverse dipping is well documented in diabetes. Some findings suggest the possibility of restoring dipping with the dosage time of antihypertensive agents. Summary Diabetes is a favorable scenario for altered BP variability, which might mediate the harmful effects of CAN. Preliminary data suggest the protective effect of targeting BP variability. However, further longitudinal outcome studies are needed. In the meantime, BP variability measures and practical expedients in antihypertensive treatment should be implemented in diabetes.

Spallone, V. (2018). Blood Pressure Variability and Autonomic Dysfunction. CURRENT DIABETES REPORT, 18(12), 137 [10.1007/s11892-018-1108-z].

Blood Pressure Variability and Autonomic Dysfunction

Spallone V.
Writing – Original Draft Preparation
2018-10-25

Abstract

Purpose of Review This review considers the relationship between abnormal blood pressure (BP) variability and autonomic dysfunction through an attempt to answer questions about its clinical relevance and pertinence to diabetes and cardiovascular autonomic neuropathy (CAN) and which therapeutic measures can lessen its cardiovascular impact. Recent Findings Office, ambulatory, and home BP monitoring identify posture-related, circadian, short-term, and long-term BP variabilities. Abnormal BP variability is a risk marker for organ damage, mortality, and cardiovascular events. Moreover, BP variability changes are common in diabetes and associated with CAN and possibly exacerbated by comorbidities like nephropathy, obstructive sleep apnoea syndrome, and chronic pain. The prognostic role of nondipping and reverse dipping is well documented in diabetes. Some findings suggest the possibility of restoring dipping with the dosage time of antihypertensive agents. Summary Diabetes is a favorable scenario for altered BP variability, which might mediate the harmful effects of CAN. Preliminary data suggest the protective effect of targeting BP variability. However, further longitudinal outcome studies are needed. In the meantime, BP variability measures and practical expedients in antihypertensive treatment should be implemented in diabetes.
25-ott-2018
Pubblicato
Rilevanza internazionale
Articolo
Esperti non anonimi
Settore MED/13 - ENDOCRINOLOGIA
English
Con Impact Factor ISI
Autonomic dysfunction; Blood pressure monitoring; Blood pressure variability; Diabetic neuropathy; Prognosis; SGLT2i; Treatment
This research has been supported by the 2017 FFABR funding for research activities of Italian National Agency for the Evaluation of the University and Research Systems (ANVUR).
Spallone, V. (2018). Blood Pressure Variability and Autonomic Dysfunction. CURRENT DIABETES REPORT, 18(12), 137 [10.1007/s11892-018-1108-z].
Spallone, V
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/205017
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