The relationship between blood pressure variability and target organ damage in elder essential hypertension combined with type 2 diabetes mellitus patients / 中国医师进修杂志

ABSTRACT

Objective To explore the relationship between blood pressure variability and target organ damage in elder essential hypertension combined with type 2 diabetes mellitus (T2DM) patients.Methods One hundred and thirty-two elder essential hypertension patients were divided into two groupssingle hypertension group (74 patients) and hypertension combined with T2DM group (58 patients).Thirty-nine cases of healthy person were chosen as control group and 61 single T2DM patients were as single T2DM group.Clinical data and ambulatory blood pressure monitoring indexes of 24-hour mean systolic blood pressure (24 h SBP),24-hour mean diastolic blood pressure (24 h DBP),diurnal mean systolic blood pressure (dSBP),diurnal mean diastolic blood pressure(dDBP),night mean systolic blood pressure(nSBP),night mean diastolic blood pressure (nDBP) were measured in the four groups.The percentage difference between dSBP and nSBP(△ SBP％),between dDBP and nDBP(△ DBP％) and target organ damage in four groups were also analyzed.Results Compared with single hypertension group,hypertension combined with T2DM group showed increased total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C) and carotid artery intimal-medial thickness (IMT) [(5.48 ± 1.03) mmol/L vs.(4.96 ± 1.14) mmol/L,(3.92 ± 0.63) mmol/L vs.(3.17 ± 0.55) mmol/L,(1.41 ± 0.19) mm vs.(0.93 ± 0.20) mm](P＜ 0.05).24 h SBP and nSBP was significantly higher in hypertension combined with T2DM group than that in single hypertension group,while 24 h DBP and dDBP was significantly lower[(145.3 ± 13.1) mm Hg(1 mm Hg =0.133 kPa) vs.(137.1 ± 12.8) mm Hg,(139.4 ± 9.9) mm Hgvs.(131.1 ± 11.6) mm Hg,(74.2 ± 9.6) mm Hgvs.(80.9 ± 9.2) mm Hg,(77.2 ± 9.1) mm Hg vs.(82.4 ± 9.3) mm Hg] (P ＜ 0.05).The incidence of target organ damage in hypertension combined with T2DM group was significantly higher than that in other groups [55.17％ (32/58) vs.27.87％ (17/61),21.62 ％ (16/74),10.26％ (4/39)] (P ＜ 0.05).Logistic regression analysis showed that age was a risk factor (OR =1.145,95％ CI1.088-1.201,P ＜ 0.05),while △ SBP％ was a protective factor (OR =0.918,95％ CI0.872-0.984,P ＜0.05).Conclusion Hypertension combined with T2DM can increase the blood pressure variability,aggravate the abnormality of the circadian rhythm of blood pressure and target organ damage.