Longitudinal study funded by the University of Pisa. Chiriacò and McLaughlin shows that adults with diabetes who experience abnormal blood pressure (PB) patterns overnight which either do not drop as expected (nondipping) or, increase at night (reverse dipping) are at a higher risk of death compared with peers with regular nighttime BP activity. Prior research has connected abnormal BP patterns with renal and cardiovascular disease in both healthy individuals and in patients diagnosed with hypertension or diabetes. The CHAMPION study included 349 diabetic adults (81% with type 2 diabetes) whose BP pattern were tracked for over 20 years, using 24-hour ambulatory BP monitoring (ABPM) and heart rate variability monitoring. Dipping, nondipping and reverse dipping is characterized by a decline of a least 10%, less than 10% and an increase of at least 0.1% in average night-time systolic BP (SBP), compared with average daytime SBP.

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