Circadian variation of blood pressure in normo- and hypertensive diabetic patients with and without nephropathy

Blood pressure control over 24 h is an important influence factor for prevention of diabetic angiopathy, i.e., diabetic nephropathy. We performed 24 h-measurements of blood pressure in normotensive and hypertensive type I- and type II-diabetic patients with different stages of nephropathy and observed the variation of circadian changes of blood pressure. The patients were divided into ''dippers'', whose nightly decrease in mean arterial pressure was greater than 10% and non-dippers with less than 10%. Even 30% of patients without nephropathy are non-dippers. We conclude that 24 h-blood pressure measurements must be required in all diabetic patients with or without nephropathy. An early therapy may prevent or slow the development of an end-stage renal failure.