COMPARISON OF BLOOD PRESSURE VARIABILITY BETWEEN 24H AMBULATORY MONITORING AND OFFICE BLOOD PRESSURE IN DIABETICS AND NON-DIABETIC PATIENTS A CROSS-SECTIONAL STUDY. (April 2021)

• Record Type: Journal Article
• Authors: Rouxinol-Dias, Ana Lídia; Gonçalves, Marta Lisandra; Silva, José; Ramalho, Diogo; Barbosa, Loide; Polónia, Jorge
• 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.0000746796.05027.2f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: To examine the relationship of different measurements of Blood Pressure Variability (BPV) both based on 24 h Ambulatory BP Monitoring (ABPM) and on visit-to-visit in office BP (OBP) evaluation in a large set of diabetic (D) and non-diabetic (ND) patients. Design and method: A total of 1123 patients with ABPM and OBP measurements were included in a single-center cross-sectional study: 272 (24%) D, 43% male, 41% dyslipidemia, ageing 52 years (range 38- 64), BMI 27.9 kg/m2 (range 24.7–31.3). Comparison of BPV between D and ND used Mann-Whitney U test and a generalized linear model (GLM) including D as only predictor and age <65 years, BMI, gender, dyslipidemia, family history of D, of hypertension, urinary sodium and eGFR as covariates. Results: Mean systolic BP (SBP) was significantly higher in D vs ND (p < 0.001), for all 24 h, daytime and nighttime periods of ABPM and for OBP. BPV in daytime ABPM was higher in D vs ND, in unadjusted analysis: coefficient of variation of SBP (CVS) for D: 9.5 (range 8.0–10.9 vs ND: 8.8 (range 7.4–10.7), p < 0.001 but no measure of OBPV showed significant differences between groups. OBPV did not correlate with 24-h BP variability. Morning rise of SBP was higher in ND group (10.9 ± 0.3 vs 9.7 ± 0.6 mm Hg (p = 0.014). GLM analysis confirmed higher ambulatory SBP variability in D vs ND. CVS (24H and daytime BP p < 0.001) was higher in D (vs ND) independently of other covariates. Arterial stiffness index (ASI) was higher (p < 0.001) in D = 0.44 (0.35 -0.56) vs ND = 0.32 (0.20 -0.44) but weakly related with BP variability. Conclusions: BP variability on ABPM was higher in diabetic vs ND. BP variability in long-term visit-to-visit in OBP was weakly correlated to short-term ABPM variability. In diabetics the lower morning rise of BP and the higher BPV in ABPM values may indicate different spectra of adjusted vs inadequate autonomic response in D. ABPM BPV may be a relevant component of pathophysiologic path involved in higher incidence of adverse events in diabetic population.