APPS November 2002 Meeting Abstract 1128

Diabetic patients have two to three fold increased risk of developing cardiovascular diseases compared with their non-diabetic counterparts¹. The advent of 24 hour ambulatory blood pressure monitor (ABPM) has led researchers to better understanding of the blood pressure load. In diabetics, the 24 hour blood pressure variability (BPV) is still poorly explored. Furthermore, several studies have shown that there is a reduction in arterial compliance in diabetes mellitus but the reduction in the arterial compliance is not significantly associated with atherosclerosis² or vessel wall thickness³. The aim of the study was to determine whether arterial compliance measured by non-invasive arterial waveform analysis is associated with BPV in non-insulin dependent diabetes mellitus (NIDDM) patients. A total of 18 patients with NIDDM and 18 matched controls were enrolled. Noninvasive 24-hour ABPM was performed with BR-102 monitor (Schiller Inc. Germany). The subject's arterial compliance was measured 1 to 4 weeks after the 24 hour BP measurement. The arterial compliance was determined using the HDI/ Pulsewave Research Cardiovascular Profiling Instrument (Hypertension Diagnostic Inc. Eagen, MN, USA). There was no significant difference in age and body weight in both groups ( 51 + 11 vs 50 + 10 years, 66.9 + 10.7 vs 65.0 + 9.7 kg). There was a significantly higher BPV in 24-hour systolic (17.7 + 6.8 vs 14.6 + 2.6 mmHg, P<0.05), diastolic (15.6 + 7.1 vs 11.4 + 3.1 mmHg, P<0.05) and mean arterial pressure (14.8 + 7.0 vs 11.1 + 2.9, P<0.05 mmHg) in NIDDM as compared to control group. The systolic, diastolic and mean arterial BPV were also significantly higher during the daytime but not during the nighttime period. The NIDDM subjects also showed significantly reduced small artery compliance (4.3 + 2.6 vs 6.1 + 3.0 ml/mmHg x 10, P<0.05) and stroke volume (68.4 + 7.7 vs 75.3 + 11.8 L/min, P<0.05) as compared to control subjects. There were no significant difference in large artery compliance, cardiac output and systemic vascular resistance. The reduction in compliance may be as a result of increased arterial stiffness due to alteration in arterial connective tissue independent of the presence of atherosclerosis.