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C-reactive protein and blood pressure variability in type 2 hypertensive diabetic patients

Schein, Andressa S.O.a,c; Bock, Patrícia M.b,e; Massierer, Danielaa; Gus, Miguela,b; Schaan, Beatriz D.a,c,d

doi: 10.1097/MBP.0000000000000362
Clinical Study

Objective Increased blood pressure (BP) variability and inflammation are included among the factors recognized as potential predictors of cardiovascular events in type 2 diabetes and hypertension. This study aimed to evaluate whether C-reactive protein (CRP) is associated with increased BP variability in diabetic-hypertensive patients.

Patients and methods We carried out a cross-sectional study with 285 diabetic-hypertensive patients, evaluating laboratory characteristics and 24-h ambulatory BP monitoring. SD, coefficient of variation (CV%), time–rate index of 24-h systolic BP (SBP), and 24-h BP patterns were evaluated. Pearson’s χ2-test, Student’s t-test, and the Mann–Whitney test were used to compare the groups. Groups were defined by CRP of up to 3 mg/l (low) and more than 3 mg/l (high).

Results The age of the patients was 59 (54–62) years; 101 (35%) were men. There was an increase in office SBP [137 (127–148) vs. 145 (130–157) mmHg] and DBP [79 (73–86) vs. 82 (76–91) mmHg] in the high CRP group. Blood pressure variability indexes were not different among groups [SD: 11.2 (9–15) vs. 12.2 (10–15) mmHg; CV%: 8.6 (7–11) vs. 9.4 (7–12); time rate: 0.55±0.12 vs.12.2 (10–15) mmHg/min]. In addition, BMI (29.3±3.8 vs. 30.9±3.6 kg/m2), total cholesterol [166 (148–190) vs. 177 (156–210) mg/dl], and HbA1c [7.5% (6.6–8.9) vs.8.3% (7.1–9.9)] were higher in the high CRP group.

Conclusion In patients with diabetes and hypertension, higher CRP levels are linked to cardiometabolic derangements, although they are not associated with increased BP variability.

aCardiology and Endocrine Divisions

bNational Institute of Science and Technology for Health Technology Assessment (iats) – CNPq/Brazil, Hospital de Clínicas de Porto Alegre

cPostgraduate Studies Program in Cardiology, School of Medicine

dInternal Medicine Department, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre

eIntegrated Colleges of Taquara, Taquara, Brazil

Correspondence to Patricia M. Bock, PhD, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350, Building 12, 4th Floor, Porto Alegre 90035 003, Brazil Tel/fax: +55 513 359 6332; e-mail:

Received March 2, 2018

Received in revised form November 30, 2018

Accepted December 18, 2018

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