University of Liège, Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium.
Diabetes Care. 2010 Nov;33(11):2424-9. doi: 10.2337/dc10-0302. Epub 2010 Aug 6.
Arterial pulse pressure is considered to be an independent cardiovascular risk factor. We compared pulse pressure during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes and corresponding nondiabetic control subjects.
Forty patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, and BMI 23.0 kg/m2) were compared with 40 nonhypertensive patients with type 2 diabetes (respectively, 50 years, 8 years, and 29.7 kg/m2). Patients taking antihypertensive agents or with renal insufficiency were excluded. All patients were evaluated with a continuous noninvasive arterial blood pressure monitoring (Finapres) in standing (1 min), squatting (1 min), and again standing position (1 min). Patients with type 1 or type 2 diabetes were compared with two groups of 40 age-, sex- and BMI-matched healthy subjects.
Patients with type 1 diabetes and patients with type 2 diabetes showed significantly higher pulse pressure, heart rate, and double product of pulse pressure and heart rate (PP×HR) (type 1: 5,263 vs. 4,121 mmHg/min, P=0.0004; type 2: 5,359 vs. 4,321 mmHg, P=0.0023) levels than corresponding control subjects. There were no significant differences between patients with type 1 diabetes and type 2 diabetes regarding pulse pressure (59 vs. 58 mmHg), heart rate (89 vs. 88/min), and PP×HR (5,263 vs. 5,359 mmHg/min).
Patients with type 1 diabetes have increased levels of peripheral PP, an indirect marker of arterial stiffness, and PP×HR, an index of pulsatile stress, comparable to those of nonhypertensive patients with type 2 diabetes at similar mean age of 50 years.
脉压被认为是心血管的独立风险因素。我们比较了中年 1 型糖尿病患者、2 型糖尿病患者和相应的非糖尿病对照者在主动直立试验中的脉压。
40 例 1 型糖尿病患者（平均年龄 50 岁，糖尿病病程 23 年，BMI 为 23.0 kg/m2）与 40 例非高血压 2 型糖尿病患者（分别为 50 岁、8 年、29.7 kg/m2）进行比较。排除服用抗高血压药物或有肾功能不全的患者。所有患者均采用连续无创动脉血压监测仪（Finapres）进行直立位（1 分钟）、蹲位（1 分钟）和再次直立位（1 分钟）评估。将 1 型或 2 型糖尿病患者与两组年龄、性别和 BMI 匹配的健康受试者进行比较。
1 型糖尿病患者和 2 型糖尿病患者的脉压、心率和脉压与心率乘积（PP×HR）（1 型：5263 比 4121 mmHg/min，P=0.0004；2 型：5359 比 4321 mmHg，P=0.0023）明显高于相应的对照组。1 型糖尿病患者和 2 型糖尿病患者的脉压（59 比 58 mmHg）、心率（89 比 88/min）和 PP×HR（5263 比 5359 mmHg/min）无显著差异。
1 型糖尿病患者外周脉压（间接反映动脉僵硬度的指标）和脉压与心率乘积（反映搏动性压力的指标）水平升高，与年龄相似的非高血压 2 型糖尿病患者相当。
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