People whose blood pressure doesn't
drop significantly overnight tend to have more cardiovascular
problems.
Now, new research at the University of Michigan
Health System and the Veterans Affairs Ann Arbor Healthcare
System indicates that they also tend to have higher
levels of glucose (blood sugar).
That could put these so-called "non-dippers" at
greater risk for developing diabetes and other diseases,
which in turn raises the risk of cardiovascular problems,
researchers say.
"We found that non-dippers experienced a higher
likelihood having increased fasting glucose than people
whose blood pressure dips by more than 10 percent
overnight," says Meredith Montero, a third-year medical
student at the University of Michigan Medical School,
who is presenting the research May 13 at the annual
meeting of the American Geriatrics Society in Orlando.
"This means that health care providers may want
to monitor these patients' glucose more closely and
emphasize to them the importance of monitoring their
blood pressure," Montero says.
Researchers studied 51 patients ages 60 to 80 who
have high blood pressure, or hypertension. Of those,
20 were non-dippers, whose blood pressure does not
drop by 10 percent at night. Most people in the general
population are "dippers," but it is common for people
with hypertension to be non-dippers.
Both groups had nearly identical average blood pressure
levels over the 24-hour period they were studied,
but the non-dippers did not have the overnight reduction
in their blood pressure experienced by the other 31
subjects.
Two blood sugar measures – fasting glucose and two-hour
oral glucose tolerance tests – differed for the two
groups, the study found. The fasting glucose level
for the dippers was 95 mg/dl on average; their two-hour
oral glucose tolerance level was 133 mg/dl. Those
numbers were 102 and 144 for non-dippers, respectively.
A fasting glucose level higher than 125 is indicative
of diabetes. Levels of 110-125 may indicate pre-diabetes,
a condition in which blood glucose levels are higher
than usual but are not at the level of diabetes. People
with pre-diabetes can prevent the onset of diabetes
with the help of exercise, weight loss and diet changes.
In addition to the potential for developing diabetes,
the higher glucose and insulin rates could contribute
to the increased rate of cardiovascular problems among
non-dippers, says Mark Supiano, M.D., professor of
geriatric medicine in the U-M Medical School's Department
of Internal Medicine, director of the Geriatric Research,
Education and Clinical Center (GRECC) at the Veterans
Affairs Ann Arbor Healthcare System, and Montero's
faculty mentor on this study.
"Since higher glucose levels are tied to such serious
health conditions, it is important that we monitor
these levels in people who appear to be at higher
risk, such as people whose blood pressure does not
drop significantly overnight," Supiano says.