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- Title
Ambulatory Blood Pressure in Hypertensive Patients with Diabetes: Analysis of a 40,000-Patient Database in Spain.
- Authors
Gorostidi, Manuel; Segura, Julian; Gonzalez-Albarran, Olga; Sobrino, Javier; De La Sierra, Alex; Banegas, Jose R.; Llisterri, Jose L.; Ruilope, Luis M.
- Abstract
Diabetes has been considered an equivalent of established cardiovascular (CV) disease in terms of risk evaluation. The aim of the study was to identify blood, pressure (BP) dependent markers of high CV risk in diabetic hypertensives using ambulatory BP monitoring (ABPM). The Spanish Society of Hypertension has developed a nation-wide project in which more than 900 primary-care physicians send ABPM registries to a central database (www.cardiorisc-com) and they receive a result report on real time. Between June 2004 and May 2006 a 40,000-case database was obtained, being 34,563 (86.4%) valid for analysis according pre-specified quality criteria. We identified 6,467 patients (18.7%) with diabetes (ADA criteria). When compared to non-diabetic hypertensives, patients with diabetes were older (64.7 vs 58.1 years) and exhibited higher systolic ABPM data (24-h 134.9 vs 130.4, daytime 137.4 vs 133.7, and nighttime 127.7 vs 120.8 mmHg, p<0.001 for all) despite they were receiving more antihypertensive drugs (mean number 1.9 vs 1.3, p<0.001). A high 24-h BP variability (SD of 24-h systolic BP >15 mmHg) was more prevalent in diabetics (15.8% vs 13.4%, p<0.001). Moreover, prevalence of a non-dipping BP profile, defined as nighttime BP decline less than 10%, (62.6% vs 49.7%, p<0.001), and a riser profile, define as an increase in nighttime BP, (20.0% vs 11.1%, p<0.001) were also higher in diabetic patients. Our data support the recommendation of considering diabetic patients at a high level of CV risk. Abnormalities in systolic BP, nocturnal BP, 24-h BP variability, and circadian BP pattern could be linked with the excess of BP-related CV risk of these patients. ABPM provides new important information in hypertensive patients with diabetes. A wider use of this technique in diabetics should be considered.
- Subjects
SPAIN; AMBULATORY blood pressure monitoring; PEOPLE with diabetes; HYPERTENSION; DIABETES
- Publication
Diabetes, 2007, Vol 56, pA269
- ISSN
0012-1797
- Publication type
Article