Aim: Higher blood pressure is a marker of increased risk for development of diabetic angiopathy. The aim of the study was to evaluate the selected factors influencing the prevalence of prehypertension in T1DM children and adolescents.
Methodology: 113 T1DM patients (62 male), aged 12-19 years, with diabetes duration from 0.5 to 17.3 years, without evidence of arterial hypertension during routine examination were recruited. In patients 24-hour automatic blood pressure (BP) monitoring was performed. Prehypertension was diagnosed SBP>120 mmHg and < 95pc and/or DBP>80 mmHg and < 95pc. Among metabolic factors body mass index (BMI), lipids profile, HbA1c and insulin sensitivity index glucose disposal rate (euglycemic hiperinsulinemic clamp) were estimated. As an early marker of autonomic neuropathy heart rate variation was measured.
Results: None of the study patients had hypertension. In 35 individuals (31%) prehypertension was diagnosed. The prehypertension group had older age (17.4 vs. 15.8 years, p<0.001), longer duration of disease (6.6 vs. 4.3 years, p=0.003), greater BMI (23.8 vs. 22.0 kg/m2, p=0.01) and lower insulin sensitivity index (5.9 vs. 7.0 mg/kg/min., p=0.04) as compared with the group with normal value of blood pressure. There were no differences between groups in lipids profile and HbA1c. In the patients with prehypertension the greater activity of sympathetic activation was observed (LF/HF--1. 0 vs. 0.82, p=0.02).
Conclusions: Prehypertension is common feature in children and adolescents with type 1 diabetes. The prevalence of prehypertension is associated with older age, longer duration of disease, greater BMI, lower insulin sensitivity and the shift of the sympathovagal balance toward sympathetic activation.