Buda Vlad Alexandru, Ciobanu Dana Mihaela, Roman Gabriela
Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Department of Diabetes and Nutrition, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Clujul Med. 2018 Oct;91(4):408-413. doi: 10.15386/cjmed-972. Epub 2018 Oct 30.
The parameters evaluated during 24-hour ambulatory blood pressure monitoring were reported to be predictors of cardiovascular events. We aimed to investigate mean blood pressure, blood pressure variability and pulse pressure during 24-hour ambulatory blood pressure monitoring in type 2 diabetes patients and to establish their relationship with the presence of atherosclerotic cardiovascular disease (CVD).
The observational study included type 2 diabetes patients randomly selected and distributed in 2 study groups depending on the presence of atherosclerotic cardiovascular disease: CVD(-), n=90, and CVD(+), n=87. Daytime, nighttime and 24-hour systolic and diastolic blood pressure were monitored and mean blood pressure, blood pressure variability and pulse pressure were calculated.
The study groups were comparable as age, gender ratio, smoking status, body mass index and abdominal circumference. Diabetes and hypertension duration were significantly higher in the CVD(+) group. Mean systolic and diastolic blood pressure, blood variability, dipper prevalence did not differ between study groups. Pulse pressure was significantly higher in the CVD(+) group compared to CVD(-) group (daytime pulse pressure 56.2±13.1 vs. 50.6±11.3 mmHg, p=0.003; nighttime pulse pressure 56.5±14.2 vs. 50.7±12.4 mmHg, p=0.005; 24-hour pulse pressure 54.7±13.6 vs. 49.0±12.0 mmHg, p=0.003).
Ambulatory pulse pressure was significantly higher in patients with type 2 diabetes and atherosclerotic cardiovascular disease compared to those without cardiovascular disease, although mean systolic and diastolic blood pressure and blood pressure variability were similar.
据报道，24小时动态血压监测期间评估的参数可预测心血管事件。我们旨在研究2型糖尿病患者24小时动态血压监测期间的平均血压、血压变异性和脉压，并确定它们与动脉粥样硬化性心血管疾病（CVD）的存在之间的关系。
这项观察性研究纳入了随机选择的2型糖尿病患者，根据是否存在动脉粥样硬化性心血管疾病分为2个研究组：CVD（-）组，n = 90；CVD（+）组，n = 87。监测白天、夜间和24小时收缩压和舒张压，并计算平均血压、血压变异性和脉压。
研究组在年龄、性别比例、吸烟状况、体重指数和腹围方面具有可比性。CVD（+）组的糖尿病和高血压病程明显更长。研究组之间平均收缩压和舒张压、血压变异性、杓型血压发生率无差异。与CVD（-）组相比，CVD（+）组的脉压明显更高（白天脉压56.2±13.1 vs. 50.6±11.3 mmHg，p = 0.003；夜间脉压56.5±14.2 vs. 50.7±12.4 mmHg，p = 0.005；24小时脉压54.7±13.6 vs. 49.0±12.0 mmHg，p = 0.003）。
与无心血管疾病的患者相比，2型糖尿病和动脉粥样硬化性心血管疾病患者的动态脉压明显更高，尽管平均收缩压和舒张压以及血压变异性相似。
