YOUNG PATIENTS WITH TYPE 1 DIABETES MELLITUS WITHOUT CARDIOVASCULAR DISEASES ARE CHARACTERIZED BY HIGH FREQUENCY OF UNFAVOURABLE BLOOD PRESSURE PHENOTYPES. (April 2021)

• Record Type: Journal Article
• Authors: Medvedev, D.; Safarova, A.; Troitskaya, E.; Stavtseva, Y.; Efimova, V.; Kobalava, Z.
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000746784.16874.45
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Type 1 diabetes mellitus (T1DM) remains a disease with high risk of cardiovascular disease (CVD). Hypertension (HTN) may be underdiagnosed in this population. Data on ABPM profile in patients with T1DM are lacking. The aim of the study was to assess the prevalence of different BP phenotypes and dipping patterns in patients with T1DM without known CVD. Design and method: Study group included 125 patients with T1DM aged 18–44 years: 60% males, 29.2 ± 7.6 years, median DM duration 6.9 years). 24-hour ABPM of brachial BP was performed with BPLab Vasotens. BP levels and phenotypes were classified according to 2018 ESC/ESH HTN guidelines. p < 0.05 was considered significant. Results: Mean office BP was 120.9 ± 14.6/77.3 ± 9.3mmHg, daytime–120.7 ± 10.4mmHg, nighttime-112.8 ± 11.4/72.6 ± 9.9mmHg, 24-h BP–119.5 ± 9.3/75.2 ± 8.7mmHg. High normal BP was registered in 9.6% HTN in 4.8%. According to ABPM measurement sustained HTN was confirmed in 4.8%, true normotension–in 72% and masked HTN was found in 23.2%. Isolated nocturnal HTN was revealed in 14.4%. Patients with sustained HTN compared to masked HTN had longer median duration of DM (14.8 vs 5.3 years) and higher median urine albumin-creatinine ratio (UACR) (33.4 vs 18.1 mg/g), p < 0.05. For further analysis patients with sustained and masked HTN were united into one group. Patients with HTN compared to normotensives were older (31.5 ± 7.9vs29.1 ± 8.2 years), higher median UACR (23.8 vs 14.5 mg/g) and received higher insulin doses (41.3vs28.6 U), p < 0.01. Median SBP diurnal index (DI) in normotensives was 10.3%, in hypertensives –6.2% (p < 0.05). Dipping profiles of SBP in patients with HTN and normotensives were as follows: 57.1% non-dippers, 20% night-peakers and 22.9% dippers vs 37.8% non-dippers and 62.2% dippers respectively (p < 0.05). Non-dipping profile (DI < 10%) compared to dipping profile was characterized by a trend to higher median UACR (27.9 vs 16.7 mg/g), longer median DM duration (7.2 vs 6.1 years), p = 0.05. Conclusions: Young patients with T1DM have high frequency of masked HTN and non-dipping profile. Worse BP phenotypes were associated with higher albuminuria. Routine ABPM may be recommended in this population in order to reveal high-risk patients and optimize the treatment. The publication was prepared with the support of the RUDN University Program 5-100