Ambulatory systolic blood pressure predicts left ventricular mass in type 2 diabetes, independent of central systolic blood pressure

摘要

OBJECTIVES: Both ambulatory and central blood pressures have been reported to correlate more closely than office blood pressure with left ventricular mass index (LVMI). The aim of this study was to test whether ambulatory systolic blood pressure (SBP) predicts LVMI independent of central SBP in patients with type 2 diabetes. METHODS: We determined office, ambulatory, and central blood pressures and performed echocardiography in 460 patients with type 2 diabetes, who participated in the CARDIPP (Cardiovascular Risk factors in Patients with Diabetes - a Prospective study in Primary care) study (ClinicalTrials.gov number NCT 01049737). RESULTS: In separate multivariable regression models, 24-h ambulatory SBP, ambulatory day time SBP, and ambulatory night-time SBP were significantly associated with LVMI, independent of central SBP, age, sex, BMI, ambulatory 24-h heart rate, known duration of diabetes, and the presence or absence of any antihypertensive medications (r=0.19, 0.17, and 0.18, respectively, P<.01). All ambulatory SBP parameters, but not central SBP, were significantly associated with LVMI independent of office SBP. CONCLUSION Ambulatory SBP predicted LVMI independent of central SBP in patients with type 2 diabetes. The use of ambulatory blood pressure measurements may be encouraged as a tool for refined risk stratification of patients with type 2 diabetes.