Nibouche-Hattab W N, Lanasri N, Zeraoulia F, Chibane A, Biad A
Department of internal medecine, Ain-Taya's hospital, University of Algiers, Algiers, Algeria.
Department of internal medecine, Ain-Taya's hospital, University of Algiers, Algiers, Algeria.
Ann Cardiol Angeiol (Paris). 2017 Jun;66(3):159-164. doi: 10.1016/j.ancard.2017.04.003. Epub 2017 May 26.
We aimed to determine the prevalence of orthostatic hypertension (OHT) in normotensive, newly diagnosed type 2 diabetics, to assess clinical, biological characteristics of those patients and evaluate the evolution of their blood pressure, after one year of follow-up.
It is an observational, prospective, cohort study, on 108 normotensive, newly diagnosed diabetics, 40 men and 68 women aged from 40 to 70 ans. OHT was defined as an increase of systolic blood pressure (SBP) ≥20mmHg and/or diastolic blood pressure (DBP) ≥10mmHg, after 1 and 2min of standing from supine position. Arterial hypertension and metabolic syndrome were respectively defined according to WHO and AHA 2009 guidelines. Clinical and biological data were collected for all patients. They had a screening for diabetic complications and a follow-up during one year. Statistical analysis was performed with Epi-Info 6.04.
We found OHT in 22 patients (20.4%). Patients with OHT had a higher SBP at lying position (P=0.029), a higher waist circumference (P=0.022) and LDL (P=0.041). They had more frequently obesity (P=0.036) left ventricular hypertrophy (P=0.024), metabolic syndrome (P=0.042) and cerebrovascular events (P=0.050) when compared with those with normal blood pressure response to orthostasis. One year after follow-up, the prevalence of permanent hypertension was significantly higher in the OHT group (P=0.0008).
Our study suggests that OHT is associated with insulin resistance syndrome and onset of sustained arterial hypertension in normotensive, newly diagnosed diabetics.
我们旨在确定血压正常的新诊断 2 型糖尿病患者中体位性高血压（OHT）的患病率，评估这些患者的临床和生物学特征，并在随访一年后评估其血压变化情况。
这是一项针对 108 名血压正常的新诊断糖尿病患者的观察性、前瞻性队列研究，其中男性 40 名，女性 68 名，年龄在 40 至 70 岁之间。OHT 定义为从仰卧位站立 1 分钟和 2 分钟后收缩压（SBP）升高≥20mmHg 和/或舒张压（DBP）升高≥10mmHg。动脉高血压和代谢综合征分别根据世界卫生组织（WHO）和美国心脏协会（AHA）2009 年指南定义。收集了所有患者的临床和生物学数据。他们接受了糖尿病并发症筛查并进行了一年的随访。使用 Epi-Info 6.04 进行统计分析。
我们在 22 名患者（20.4%）中发现了 OHT。患有 OHT 的患者卧位时 SBP 更高（P = 0.029），腰围更大（P = 0.022），低密度脂蛋白（LDL）更高（P = 0.041）。与体位性血压反应正常的患者相比，他们更常出现肥胖（P = 0.036）、左心室肥厚（P = 0.024）、代谢综合征（P = 0.042）和脑血管事件（P = 0.050）。随访一年后，OHT 组永久性高血压的患病率显著更高（P = 0.0008）。
我们的研究表明，OHT 与血压正常的新诊断糖尿病患者的胰岛素抵抗综合征和持续性动脉高血压的发生有关。
