Microvascular disease, a condition during which the small arteries in the heart become narrowed, is more common in women and in people who have Type 1 diabetes or high blood pressure. Narrowing of the small arteries leads to complete occlsuion (capillary obliteration).
Damage to the cardiovascular system is necessary to be explored before the disease is well established. Therefore, a recent study explores the use of such early investigation techniques as 24-hr blood pressure monitoring, nailfold capillaroscopy, laser doppler flowmetry, and retinal vessel analysis in a paediatric and adolescent population with type 1 diabetes.
Alternative Methods for Early Detection
24-hr blood pressure monitoring is an alternative to traditional clinic blood pressure monitoring and provides numerous advantages, such as:
- repetative blood pressure measurements are taken
- over a 24-hr period
- included night-time blood pressure.
The 24-hr blood pressure profile consists of the systolic and diastolic blood pressure for the active (day) and passive (night) periods with pulse, mean arterial pressure, hypertension load, hypertensive time index and diurnal (day/night) index.
The diurnal index explores the daytime and nighttime blood pressure ratio. If the ratio is below 10%, diabetes, target organ damage or a non-efficient antihypertensive drug treatment should be considered.
During a nailfold capillaroscopy a drop of oil is placed on the patient's skin at the base of the nail, which is examined under a microscope to look for abnormalities of the capillaries. Some studies have found morphological abnormalities in adult populations with type 1 diabetes.
Laser doppler flowmetry is a method for assessing microvascular blood floow. Response differences may be shown between patients with and without type 1 diabetes.
Retinal vessel analysis is a technique to assess the behaviour of large retinal vessels based on diameter measurements. Earlier studies found that there is a relationship between a wider arteriolar diameter and retinopathy in adolescents with type 1 diabetes.
24-hour blood pressure monitoring, nailfold capillaroscopy, laser dopplet flowmetry and retinal vessel analysis showed microvascular changes in participants. According to study findings, type 1 diabetes associated microvascular complications can be detected earlier by these alternative methods.
Meditech 24-hour blood pressure monitors (ABPM-05 and ABPM-04) have been used to carry out the study. Meditech is an expert manufacturer of Holter blood pressure monitors and ECG devices from the EU and comitted to lower the risks of cardiovascular diseases worldwide.