title: Masked hypertension in type 2 diabetes mellitus. Relationship with left-ventricular structure and function.
abstract: BACKGROUND
  To evaluate in type 2 diabetes mellitus the relationship between masked hypertension (MH) and left ventricular (LV) morpho-functional characteristics.
  
  
  METHODS
  Using 24-hour BP monitoring and echocardiography, we evaluated 71 type 2 diabetic patients, without overt cardiac disease and never treated with antihypertensive drugs: 45 normotensive subjects with clinic BP <130/85 mmHg and 26 sustained hypertensives (SH)(clinic BP > or = 140 and/or 90 mmHg and 24-hour BP > or =125 and/or 80 mmHg), matched for age, gender, BMI and duration of diabetes with clinically normotensive patients. MH was diagnosed with clinic BP <130/85 mmHg and 24-hour BP > or =125 and/or 80 mmHg.
  
  
  RESULTS
  Among clinically normotensive patients, 21 (47%) had MH and 24 were true normotensive (NT, 24-hour BP <125/80 mmHg). LV mass increased from NT to MH to SH (p < 0.001); the parameters of LV diastolic function were similar between MH and SH and significantly lower than in NT.
  
  
  CONCLUSIONS
  In type 2 diabetic patients with clinic BP <130/85 mmHg, MH is frequent and is associated with LV remodelling characterized by increased myocardial mass and preclinical impairment of LV diastolic function; the remodelling is qualitatively and for some aspects also quantitatively similar to that found in sustained hypertensive patients. Therefore it would be useful to look for MH in diabetic subjects with clinic BP <130/85 mmHg, who, following the guidelines, are not entitled to antihypertensive treatment: the finding of MH could identify a subgroup of patients at higher cardiovascular risk and therefore needing a prompt antihypertensive treatment.
authors: Department of Clinical Medicine, University of Insubria, Varese, Italy. chiara.mrc@gmail.com
authors: Chiara
authors: C
authors: Marchesi
authors: Andrea Maria
authors: AM
authors: Maresca
authors: Francesco
authors: F
authors: Solbiati
authors: Ivano
authors: I
authors: Franzetti
authors: Emanuela
authors: E
authors: Laurita
authors: Eleonora
authors: E
authors: Nicolini
authors: Monica
authors: M
authors: Gianni
authors: Luigina
authors: L
authors: Guasti
authors: Patrizio
authors: P
authors: Marnini
authors: Achille
authors: A
authors: Venco
authors: Anna Maria
authors: AM
authors: Grandi
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000473:pathology / Q000503:physiopathology*; D020257:Ventricular Remodeling
chemical_list: D000959:Antihypertensive Agents