Effect of smoking on 24-hour ambulatory blood pressure in normoalbuniuric type 2 diabetes mellitus patients

الملخص EN

Several studies have documented the relationship of smoking to the development of nephropathy in type 2 diabetes.

The pathophysiological mechanisms by which smoking produce these effects are not definitely known.

A possible link could be elevated blood pressure, which is a known risk factor for cardiovascular disease and also closely associated with development and progression of diabetic nephropathy.

The aim of this work is to study the effects of cigarette smoking on 24-h ambulatory blood pressure in a group of normoalbuminuric type 2 diabetes mellitus patients.

Material and Methods.

The study comprised 50 normoalbuminuric type 2 diabetic patients divided into two groups, 25 nonsmokers and 25 smokers; both groups were matched for age, sex, and diabetes duration.

All participants were subjected to: Thorough medical history and clinical examination including cardiovascular autonomic reflex tests, measurement of the urinary albumin excretion (UAE), fasting plasma glucose (FPG), glycohemoglobin (HbAlc), and twenty four hour ambulatory blood pressure monitoring (24-h AMBP).

Results.

The mean arterial pressure (MAP) both daytime and nighttime were significantly higher in the smokers compared to the nonsmokers [100 + 8.2 vs 95 + 6.5 mmHg (p < 0.05) & 86 + 9.2 vs 78+5.6mmHg (p<0.001) respectively].

Also, the diastolic AMBP both daytime and nighttime were significantly higher in the smokers compared to the nonsmokers [84 + 7.3 vs 78 ± 5.2 mmHg (p < 0.01) & 70 + 9.2 vs 62 + 5.5 mmHg (p<0.001) respectively].

The systolic AMBP both daytime and nighttime were not statistical significant different in the smokers compared to the nonsmokers (p>0.05).

The mean and diastolic nocturnal dipping were significantly reduced in the smokers compared to the nonsmokers [14.5+3.3 vs 17.8 ± 3.4 % (p < 0.01) and 16.6 ± 3.8 vs 20.5 + 2.5 % (p < 0.001) respectively].

Also, the 24-h heart rate was significantly higher in the smokers compared to the nonsmokers [80 + 7.3 vs 71+ 9.5 beats / min (p < 0.001)].