Background: We investigated the efficiency of ambulatory blood pressure monitoring (ABPM) in detecting early alterations in blood pressure (BP) in young patients with mild to moderate hypertension and type 1 diabetes mellitus (DM), and sought correlations between ABPM values and the type of left ventricular (LV) hypertrophy.

Methods: The study included 23 young adults (19 males, 4 females; mean age 26±5 years) with mild to moderate hypertension and type 1 DM. The patients were evaluated by casual BP measurements and 24-hour ABPM monitoring and were classified as dippers and nondippers according to the nocturnal decrease in BP compared to daytime values (>10% and <10%, respectively). All patients underwent complete two-dimensional transthoracic echocardiography and Doppler evaluations. The results of ABPM were evaluated in relation to left ventricular parameters and geometry. Measurements of BP were compared with a control group consisting of 25 age-matched healthy individuals (21 males, 4 females; mean age 28±4 years).

Results: Eleven patients were classified as dippers and 12 patients as nondippers. There were no significant differences between dipper and nondipper patients with respect to age, gender, body mass index, clinical features, and casual and ABPM recordings. All echocardiographic M-mode variables were similar in both patient groups. Concentric hypertrophy was the most frequent LV geometric pattern in the dipper group (45.5%), followed by normal geometry (27.3%), concentric geometry (18.2%), and eccentric hypertrophy (9.1%). In the nondipper group, the most common pattern was eccentric hypertrophy (41.7%), followed by concentric hypertrophy (25%), concentric remodeling (25%), and normal geometry (8.3%). The incidence of eccentric hypertrophy was significantly higher in nondippers (p=0.017).

Conclusion: Nondipping status revealed by ABPM may have a significant impact on LV geometry and determine the type of LV hypertrophy in hypertensive patients with type 1 DM.

Keywords : Blood pressure determination/methods; blood pressure monitoring, ambulatory; diabetes mellitus, type 1; hypertension/complications; hypertrophy, left ventricular/etiology