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Prevalence and distinguishing features of masked hypertension in type 2 diabetic patients
Journal of Diabetes and its Complications, 08/21/2012
Clinical Article
Zhou J et al. – A significant fraction of type 2 diabetes mellitus patients (T2DM) patients were diagnosed with masked hypertension (MH). Clinical presentation also contrasted sharply from essential hypertensive (EH), MH is a specific blood pressure status that may severely damage target organs in T2DM.
Methods- Clinical blood pressure (CBP) and ambulatory blood pressure (ABP) were measured in 856 T2DM patients to differentiate normotensive (NT), essential hypertensive (EH), and MH.
- Waist circumference (WC), abdominal circumference (AC), body mass index (BMI), waist to height ratio (WHtR), fasting blood glucose (FBG), and glycated hemoglobin levels were measured and compared between BP groups.
- In total, 359 patients had normal CBP, of which 13.37% were diagnosed with MH based on established criteria.
- Males had significantly higher rates of MH (15.30%) than females (11.36%) (P=0.036).
- The MH detection rate increased with age and T2DM duration.
- There were no significant differences in BMI, WC or WHtR between total MH and EH groups.
- MH females, however, had lower BMIs than female EH females (P=0.023).
- Smoking, alcohol, and familial EH history were lower in MH than EH patients (smoking, P=0.029; alcohol ,P=0.001; and EH history, P=0.000), while BMI (male, P=0.037, female, P=0.015), WC (male, P=0.012, female, P=0.021), WHtR (P=0.011), smoking (P=0.016), and alcohol consumption (P=0.000) were higher in MH than NT patients.
- BMI, WHtR, 6–15year disease course of diabetes, smoking and alcoholism were independent risk factors of T2DM complicated with MH.
- The dipper BP circadian pattern was significantly lower in MH than NT patients (P=0.001).
- The non–dipper pattern was lower in MH than EH (P=0.018) but higher than in NT (P=0.000).