PECULIARITIES OF DIURNAL BLOOD PRESSURE PROFILE IN PATIENTS WITH ARTERIAL HYPERTENSION, PREDIABETESAND TYPE 2 DIABETES
Abstract
The purpose of this study is to assess the features of diurnal blood pressure profile (DBPP) in patients with arterial hypertension (AH) and prediabetes or type 2 diabetes. The study included 133 patients with AH, 30 without disturbed carbohydrate metabolism, 73 with prediabetes and 30 with type 2 diabetes. All patients underwent 24-hour blood pressure monitoring (BPM) using the BPLab Vasotens complex. The study concluded that in patients with AH in combination with prediabetes the DBPP parameters were comparable to those of patients with AH and type 2 diabetes. Furthermore, in case of disturbed carbohydrate metabolism most parameters were reliably higher than those with isolated AH, at that the most significant differences were in the parameters of pulsatile, systolic and diastolic blood pressure (SBP and DBP), mainly at night. It is important that in patients with AH with disturbed carbohydrate metabolism a more pronounced «pressure load» was detected, predominantly at night. When assessing the diurnal profile in patients with AH with prediabetes, an unfavorable type of the «non-dipper» curve was more often detected, as in patients with type 2 diabetes. Thereby, in patients with AH in combination with prediabetes, unlike to patients without disturbed carbohydrate metabolism, there were more significant pathological changes in the parameters of the DBPP, which were comparable to those with AH and type 2 diabetes.
About the Authors
S. R. Gutova
Kuban State Medical University
Russian Federation
Russian Federation
A. V. Fendrikova
Kuban State Medical University
Russian Federation
Russian Federation
M. V. Skibitskaya
City polyclinic № 3
Russian Federation
Russian Federation
References
1. Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность факторов риска развития сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией// Кардиология.2014;10:4-12.
2. Дедов И.И., Шестакова М.В. , Викулова О.К. Эпидемиология сахарного диабета в Российской Федерации: клинико-статистический анализ по данным Федерального регистра сахарного диабета// Сахарный диабет. 2017; 20(1): 13-41.
3. ESH/ESC Task Force for the Management of Arterial Hypertension. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension // Hypertension. 2013;10 (31):1925 -1938.
4. Дедов И.И., Шестакова М.В. Сахарный диабет и артериальная гипертензия.-М.:ООО «Медицинское информационное агенство», 2006.-344с.
5. Дедов И.И., Шестакова М.В. , Майорова А.Ю. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Клинические рекомендации, 8-й выпуск.- М.,2017.112с.
6. ESC Guidelines on diabetes, prediabetes, and cardiovascular diseases developed in collaboration with the EASD // European Heart Journal. 2013; 34: 3035-3087.
7. Qiu M., Shen W., Song X., et al. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus: longitudinal study// Hypertension. 2015; 65(3):525-30.
8. Nwose E.U., Richards R.S., Bwititi P.T., et al. Prediabetes and cardiovascular complications study (PACCS): international collaboration 4 years' summary and future direction//BMC Research Notes. 2017;10:730.
9. Щендрыгина А.А. Нарушения микроциркуляции у больных ишемической болезнью сердца и сахарным диабетом 2 типа//Сеченовский вестник. 2014; 4(18):27-33.
10. Grossman E. Ambulatory blood pressure monitoring in the diagnosis and management of hypertension//Diabetes care.2013;36:307-311.
11. Gorostidi M., de la Sierra A., Gonzalez-Albarran O., et al. Abnormalities in ambulatory blood pressure monitoring in hypertensive patients with diabetes//Hypertension Research.2011;34:1185-1189.
12. Скибицкий В.В., Киселев А.А., Фендрикова А.В. Эффективность комбинированной антигипертензивной терапии с учетом солечувствительности пациентов с неконтролируемой артериальной гипертонией и сахарным диабетом 2 типа//Проблемы женского здоровья.2016;4(11):15-24.
13. O’Brien E., Parati G., Stergiou G., et al., on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. Guidelines European Society of Hypertension Position Paper on Ambulatory Blood Pressure Monitoring//Hypertension. 2013;31:1731-68.
14. Ikdeda T., Matsubara T., Sato Y., Sakamoto N. Circadian blood perssure variation in diabetic patients with autonomic neuropathy// Hypertens. 1993; 11: 581-587.
15. Nakano S., Fukuda M., Hotta F. et al. Reversal circadian blood pressure rhythm is associated with occurance of both fatal and non-fatal vascular events in NIDDM subjects// Diabetes. 1998; 47: 1501-1506.
Review
Views:
633
Email this article 