Title:Circadian Rhythm of Blood Pressure in Diabetes Mellitus: Evidence, Mechanisms and Implications
Volume: 8
Issue: 5
Author(s): Elena Matteucci and Ottavio Giampietro
Affiliation:
Keywords:
Ambulatory Blood Pressure Monitoring, Circadian Rhythm, Midline Estimating Statistic of Rhythm, Acrophase,
Outcome Assessment, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Essential Hypertension, Circadian misalignment, endogenous circadian systems
Abstract: Circadian misalignment has been implicated in the development of diabetes mellitus and cardiovascular disease.
Circadian rhythms of blood pressure (BP) and heart rate (HR) have long been known and the mechanisms controlling
them have been actively investigated in physiology and disease. In this respect, the introduction of 24-hour ambulatory
blood pressure monitoring (ABPM) has enabled a more accurate assessment of circadian BP patterns in order to solve
diagnostic uncertainty or to establish dipper status. However, attention has been mainly focused on measures of extent
(midline estimating statistic of rhythm, MESOR, and amplitude) rather than timing (acrophase) of changes within a cycle.
The review summarises 1) evidence for altered characteristics of BP rhythm (in particular, phase shifts along the time
axis) in animal and human diabetes mellitus, 2) the mechanisms that have been supposed to underlie the observed changes
in cardiovascular function before diabetes onset and during progression of the disease, and 3) the adverse consequences
that may result from an altered circadian BP rhythm.
