Blood pressure phenotypes in young patients with type 1 diabetes
https://doi.org/10.15829/1560-4071-2020-3-3729
Abstract
Aim. To study phenotypes of clinic and 24-hour ambulatory blood pressure (BP), to determine their associations with arterial stiffness parameters, and to assess global cardiovascular risk (CVR) in young patients with type 1 diabetes (T1D).
Material and methods. The presented cross-sectional single-center study included 81 T1D patients without a history of hypertension (HTN) and other cardiovascular diseases (CVD) (men — 39%; median age — 27 years; median duration of T1D — 6 years). All participants underwent a routine clinical and laboratory testing, measurement of clinic and 24-hour ambulatory BP (BPLab Vasotens), assessment of central BP and arterial stiffness parameters using applanation tonometry technique. BP phenotypes were analyzed with diagnostic criteria for HTN by ESC/ESH 2018 guidelines. CVR was assessed using the SCORE 10-year risk calculator (ESC 2019). The differences were considered significant at p<0,05.
Results. The prevalence of true HTN was 6,2%, masked HTN — 38,3%. Isolated nocturnal HTN was revealed in 30,7% of patients with clinic BP <140/90 mm Hg. The subgroup with masked HTN was dominated by patients with normal clinic BP (58,1%) and in most cases was characterized by isolated diastolic BP increase (64,5%). Masked HTN was associated with a higher carotid-femoral pulse wave velocity (PWV) (median — 7,2 versus 6,3 m/s, p=0,002). The most common profiles of nocturnal BP decrease were non-dipper (63.9%) and night-picker (16.6%). High and very high CVR was recorded in 87,7% of patients. Conclusion. Hypertension occurs in 44,5% of young patients with type 1 diabetes and is characterized by a high prevalence of masked isolated nocturnal HTN and non-dipping. Masked HTN is associated with a higher carotid-femoral PWV. High and very high 10-year CVR was recorded in 87,7% of patients.
About the Authors
Zh. D. KobalavaMoscow
Yu. V. Stavtseva
Russian Federation
Moscow
E. A. Troitskaya
Moscow
A. F. Safarova
Moscow
A. E. Petrosyan
Moscow
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Review
For citations:
Kobalava Zh.D., Stavtseva Yu.V., Troitskaya E.A., Safarova A.F., Petrosyan A.E. Blood pressure phenotypes in young patients with type 1 diabetes. Russian Journal of Cardiology. 2020;25(3):3729. https://doi.org/10.15829/1560-4071-2020-3-3729