Ambulatory systolic blood pressure predicts left ventricular mass in type 2 diabetes, independent of central systolic blood pressure.
OBJECTIVE
Both ambulatory and central blood pressures have been reported to correlate more closely than office blood pressure with left ventricular mass index (LVMI). The aim of this study was to test whether ambulatory systolic blood pressure (SBP) predicts LVMI independent of central SBP in patients with type 2 diabetes.


METHODS
We determined office, ambulatory, and central blood pressures and performed echocardiography in 460 patients with type 2 diabetes, who participated in the CARDIPP (Cardiovascular Risk factors in Patients with Diabetes - a Prospective study in Primary care) study (ClinicalTrials.gov number NCT 01049737).


RESULTS
In separate multivariable regression models, 24-h ambulatory SBP, ambulatory day time SBP, and ambulatory night-time SBP were significantly associated with LVMI, independent of central SBP, age, sex, BMI, ambulatory 24-h heart rate, known duration of diabetes, and the presence or absence of any antihypertensive medications (r=0.19, 0.17, and 0.18, respectively, P<0.01). All ambulatory SBP parameters, but not central SBP, were significantly associated with LVMI independent of office SBP.


CONCLUSIONS
Ambulatory SBP predicted LVMI independent of central SBP in patients with type 2 diabetes. The use of ambulatory blood pressure measurements may be encouraged as a tool for refined risk stratification of patients with type 2 diabetes.
Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. magnus.wijkman@liu.se
Magnus
M
Wijkman
Toste
T
Länne
Ewa
E
Grodzinsky
Carl Johan
CJ
Ostgren
Jan
J
Engvall
Fredrik H
FH
Nystrom
D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D014463:Ultrasonography