• Raja Zafar Ahmed
  • Khalid Mahmood Qureshi
  • Misbahul Islam Khan


This study was designed to see whether there is a circadian variation in the frequency of acute pulmonary edemain diabetic and non-diabetic patients with ischemic heart disease. Total 150 patients (80 diabetics, 70 non-diabetic)of both sexes age range between 34-72 years with the diagnosis of acute pulmonary edema were included in this study.Out of 80 diabetics, 28 had associated hypertension, white 16 patients from non-diabetic group were hypertensive. Itwas found that there was significant circadian variation in the onset of acute pulmonary> edema in non-diabeticpatients but diabetic patients did not exhibit a circadian variation in the onset of acute pulmonary edema


Muller. JF. Stone PH. Turi ZG et al: Circadian

variation in the frequency of onset of acute myocardial

infarction. N Engl .1 Med 1985: 313: 1315-22

Bernard GR and Brigham KL: Pulmonary edema

pathophysiologic mechanisms and new approaches to

therapy. Chest 1986: 89: 594

Snapper JR and Brigham K.I.: Pulmonary edema. Hosp

Pract 1986; 21 87.

Sprung CL. Rackow LC, Fein la et al I he spectrum of

pulmonary edema: Differentiation of

cardiogenic, intermediate, and non-cardiac forms of

pulmonary edema. Ann Rev Respir Dis 1981: 124: 718.

Szidon. IP. Pietro GG. Fishman AP: The alveolar

capillary membrane and pulmonary edema. N Engl .1

Med 1972: 286: 1200.

Murray. IF: The lungs and heart failure. Hosp Pract

; 20: 55.

WHO Study group on diabetes mellitus. diabetes

mellitus technical report series No 727 Geneva VVI It)


The Guidelines Sub-Committee of The WIIOMS Mild

hypertension liaison committee 1993 Guidelines for the

management of mild hypertension 1993; 22 392.

Barash D. Silverman RA, Gennis P et al: Circadian

variation in the frequency of myocardial infarction and

death associated with acute pulmonary edema. .1

Lmerg Med 1989: 7: 119-21.

Voutilainen S. Kupasi M. Hippelainen et al: Circadian

variation of left ventricular diastolic function in

health’s people. Heart 1996; 75 35-39.

l ava S. Azzopardi J. Agius Muscat M et al: Absence of

circadian variation in the onset of acute myocardial

infarction in diabetic subjects. Br Heart J 1995; 74:

- 72.

Bernard I. Ricordi I. Lazzari P et al: Impaired

circadian modulation of sympathovagal activity in

diabetes - a possible explanation for altered temporal

onset of cardiovascular disease. Circulation 1992: 86: