OBJECTIVES: To explore the prevalence of various categories of hypertension in diabetic patients, and assess any corresponding associations with end-organ complications. DESIGN: Cross-sectional study. SETTING: Tertiary centre of a regional hospital in Hong Kong. PATIENTS: All ambulatory type 2 diabetic patients attending our clinics from January 2002 to November 2004 were invited to participate in the protocol. RESULTS: A total of 133 diabetic patients were included; 82 had normal clinic blood pressures, 15 (18%) of whom had masked hypertension, the remaining 67 (82%) had 'normotension'. The remaining 51 patients had high clinic blood pressures, of whom 28 (55%) had white-coat hypertension and 23 (45%) had sustained hypertension. Urinary albumin excretion rate was higher in patients with masked hypertension (10 mg/day; range, 7-580 mg/day) and sustained hypertension (7 mg/day; 7-3360 mg/day) in comparison to those with white-coat hypertension (7 mg/day; 7-109 mg/day) or 'normotension' (7 mg/day; 7-181 mg/day) [P<0.01]. Likewise, the prevalence of albuminuria was significantly higher in patients with masked hypertension (40%) and sustained hypertension (26%) than in those with 'normotension' (6%) and white-coat hypertension (11%) [P<0.01]. The prevalence of left ventricular hypertrophy was significantly higher in subjects with masked hypertension (38%) and sustained hypertension (26%) compared to patients with 'normotension' (8%) or white-coat hypertension (11%) [P<0.01]. Left ventricular diastolic dysfunction was more prevalent in patients with masked hypertension (46%), sustained hypertension (48%), and white-coat hypertension (43%) in comparison to subjects with 'normotension' (18%) [P=0.01]. CONCLUSION: Masked hypertension is associated with a higher prevalence of albuminuria, left ventricular diastolic dysfunction, and hypertrophy. White-coat hypertension carries a more benign prognosis than sustained hypertension and masked hypertension. Our cross-sectional study supports the recommendation to performing ambulatory blood pressure measurements in type 2 diabetic patients.
OBJECTIVES: To explore the prevalence of various categories of hypertension in diabeticpatients, and assess any corresponding associations with end-organ complications. DESIGN: Cross-sectional study. SETTING: Tertiary centre of a regional hospital in Hong Kong. PATIENTS: All ambulatory type 2 diabeticpatients attending our clinics from January 2002 to November 2004 were invited to participate in the protocol. RESULTS: A total of 133 diabeticpatients were included; 82 had normal clinic blood pressures, 15 (18%) of whom had masked hypertension, the remaining 67 (82%) had 'normotension'. The remaining 51 patients had high clinic blood pressures, of whom 28 (55%) had white-coat hypertension and 23 (45%) had sustained hypertension. Urinary albumin excretion rate was higher in patients with masked hypertension (10 mg/day; range, 7-580 mg/day) and sustained hypertension (7 mg/day; 7-3360 mg/day) in comparison to those with white-coat hypertension (7 mg/day; 7-109 mg/day) or 'normotension' (7 mg/day; 7-181 mg/day) [P<0.01]. Likewise, the prevalence of albuminuria was significantly higher in patients with masked hypertension (40%) and sustained hypertension (26%) than in those with 'normotension' (6%) and white-coat hypertension (11%) [P<0.01]. The prevalence of left ventricular hypertrophy was significantly higher in subjects with masked hypertension (38%) and sustained hypertension (26%) compared to patients with 'normotension' (8%) or white-coat hypertension (11%) [P<0.01]. Left ventricular diastolic dysfunction was more prevalent in patients with masked hypertension (46%), sustained hypertension (48%), and white-coat hypertension (43%) in comparison to subjects with 'normotension' (18%) [P=0.01]. CONCLUSION: Masked hypertension is associated with a higher prevalence of albuminuria, left ventricular diastolic dysfunction, and hypertrophy. White-coat hypertension carries a more benign prognosis than sustained hypertension and masked hypertension. Our cross-sectional study supports the recommendation to performing ambulatory blood pressure measurements in type 2 diabeticpatients.
Authors: Stanley S Franklin; Lutgarde Thijs; Yan Li; Tine W Hansen; José Boggia; Yanping Liu; Kei Asayama; Kristina Björklund-Bodegård; Takayoshi Ohkubo; Jørgen Jeppesen; Christian Torp-Pedersen; Eamon Dolan; Tatiana Kuznetsova; Katarzyna Stolarz-Skrzypek; Valérie Tikhonoff; Sofia Malyutina; Edoardo Casiglia; Yuri Nikitin; Lars Lind; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Jan Filipovsky; Yutaka Imai; Jiguang Wang; Hans Ibsen; Eoin O'Brien; Jan A Staessen Journal: Hypertension Date: 2013-03-11 Impact factor: 10.190