Diabetic nephropathy may develop in childhood and is often related to
hypertension. The 24-hour ambulatory blood pressures were measured in 63
children with insulin-dependent diabetes mellitus and were compared with
those of 54 healthy siblings. The patients were without clinical
complications. The 24-hour recording of their blood pressures revealed
higher 24-hour systolic blood pressure (SEP) (115.8 +/- 8.2), 24-hour
diastolic blood pressure (DBP) (67.5 +/- 4.6), 24-hour mean arterial
pressure (MAP) (81.8 +/- 5.2) compared with control subjects: 24-hour
SEP (112.7 +/- 6.7), 24-hour DBP (64.7 +/- 4.1), 24-hour MAP (78.9 +/-
4.5) (p = 0.03, p = 0.001, p = 0.002, respectively). Of the daytime
blood pressures, SEP, DBP, MAP were also higher (117.7 +/- 8.7, 69.7 +/-
5.2, 83.8 +/- 5.8) compared with those of siblings (114.9 +/- 6.9, 67.3
+/- 4.3, 81.1 +/- 4.9) (p = 0.05, p = 0.009, p = 0.008, respectively).
Of the nighttime blood pressures, SEP, DBP, MAP were higher in patients
(108.7 +/- 8.9, 59.5 +/- 6.9, 74.6 +/- 6.9) compared with control
subjects (104.8 +/- 7.0, 55.1 +/- 5.0, 70.5 +/- 5.1) (p = 0.01, p =
0.0002, p = 0.0006, respectively). Furthermore, the blood pressure
burden was evaluated. Blood pressure burden was defined as the
percentage of the increased blood pressure readings greater than the
95th percentile divided by the total number of recorded blood pressures
during a corresponding period. Patients had a 43% higher 24-hour SEP
burden (19.6 +/- 16.5) and a 50% higher 24-hour DBP burden (12.3 +/-
9.6) in relation to that of control subjects (13.7 +/- 12.8, 8.3 +/-
12.3) (p = 0.03, p = 0.009, respectively). The SEP burden (17.9 +/-
14.6) and DBP burden (11.5 +/- 9.2) of the day was approximately 50%
higher in the patients in relation to control subjects (11.9 +/- 11.1,
7.8 +/- 6.7) (p = 0.01, p = 0.01, respectively). Therefore it seems that
hemodynamic changes may appear early in children with diabetes
