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The characteristics of 24-hour ambulatory blood pressure monitoring and its relationship with cardiovascular target organ damage in Chinese Han patients with concomitant type 2 diabetes and hypertension

Li, Shengbing,*; Wang, Xin,*; Zhao, Lu; Chen, Min; Long, Jiangchuan; Cheng, Wei; Liu, Yongjian; Long, Min; Liu, Dongfang

doi: 10.1097/MBP.0000000000000389
Clinical Methods and Pathophysiology
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Objective: The objective of this study was to investigate the characteristics of 24-hour ambulatory blood pressure monitoring and its relationship with cardiovascular target organ damage (left ventricular hypertrophy and carotid atherosclerosis) in Chinese Han patients with concomitant type 2 diabetes mellitus and hypertension.

Methods: A total of 830 hypertensive patients with or without type 2 diabetes mellitus were divided into four groups according to blood pressure patterns. Clinical characteristics and 24-hour ambulatory blood pressure monitoring indexes were compared among the four groups. Multivariable logistic regression was used to identify the associations among clinical characteristics, blood pressure variability and cardiovascular target organ damage.

Results: The prevalence of the non-dipper blood pressure profile (51.32% vs. 24.33%) was higher in patients with type 2 diabetes mellitus and hypertension than in those without type 2 diabetes mellitus. Logistic regression analysis showed that glycosylated haemoglobin A1c, 24hSBP, 24hSSD, dSBP, nSBP and nSSD were independently associated with the non-dipper blood pressure pattern. Type 2 diabetes mellitus patients with the non-dipper blood pressure pattern showed a higher occurrence of target organ damage compared to patients in the other three groups. Multivariate regression analyses revealed that duration of hypertension, fasting blood glucose, dDBP and nDSD were associated with left ventricular hypertrophy. Age, haemoglobin A1c, LDL-C, nSBP and HDL-C were independently related to carotid atherosclerosis.

Conclusion: In the Chinese Han population, patients with concomitant type 2 diabetes mellitus and hypertension showed a remarkably high prevalence of non-dipper blood pressure patterns. Abnormal systolic blood pressure level and hyperglycemia were significantly associated with a non-dipper blood pressure pattern. Non-dipper blood pressure pattern, hyperglycemia and dyslipidemia were closely related to left ventricular hypertrophy and carotid atherosclerosis.

Department of Endocrinology and Metabolism, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

* Shengbing Li and Xin Wang contributed equally to this work.

Received 23 January 2019 Accepted 23 April 2019

Correspondence to Dongfang Liu Department of Endocrinology and Metabolism, the Second Affiliated Hospital, Chongqing Medical University. NO.74 Linjiang road, Yuzhong district, Chongqing, China, Tel: +86 18623407751; fax: +86-023-63693191; e-mail: ldf023023@qq.com

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