The Relationship Between Ambulatory Blood Pressure And Target Organs Damage In Inpatients With Type 2 Diabetes Mellitus Comb Ined With Hypertension

Objective To investigate and discuss the relationship between ambulatory blood pressure and target organ damage in inpatients of type 2 diabetes mellitus(T2DM) combined with hypertens ion.Methods Retrospectively analyzed the data of 460 cases of inpatients with type 2 diabetes mellitus combined with hypertension. During hospitalization all patients were given perfect ambulatory blood pressure monitoring, basing on which we explored and discussed the change situation of various indexes and the relationship of the prevalence between the monitoring results and coronary heart disease, cerebral stroke, diabetic nephropathy and diabetes peripheral neuropathy.Results: According to the results of 24 h ambulatory blood pressure monitoring we divided all patients into non-dipper group(324 cases in total, accounting for 70.4%) and dipper group(136 cases in total, accounting for 29.6%).In the dipper group, the the average systolic blood pressure of 24 hours( 24 h SBP)、 the average systolic blood pressure of the night(n SBP)、the average diastolic blood pressure of the night(n DBP)、the systolic blood pressure standard deviation of 24 hours(24h SSD)、the systolic blood pressure standard deviation of the night(n SSD)、the average pulse pressure of 24 hours(24h PP)、the average pulse pressure of the day(d PP)、 the average pulse pressure of the night(n PP) are lower than those of the non-dipper group, while the the percentage of systolic blood pressure fall of the night(SBPF)、the percentage of diastolic blood pressure fall of the night(DBPF) of the non-dipper group are obviously lower than the dipper group. As for the two groups, the age, the ratio of urinary microalbumin to creatinine, prevalence of ischemic stroke and coronary heart disease of the non-dipper group are higher than the dipper group. Respectively, the result of the logistic regression analys is by taking the coronary heart disease, ischemic stroke, diabetic nephropathy and diabetes peripheral neuropathy as dependent variables shows that, SBPF [OR:0.935; 95%CI:1.003–1.067; P = 0.034] 、 Low-Dens ity Lipoprotein [OR:1.494; 95%CI:1.123–1.988; P = 0.006]is related to coronary heart disease; the diastolic blood pressure standard deviation of the day(d DSD)[OR:1.117; 95%CI:1.011–1.235; P = 0.029] is related to ischemic stroke; SBPF[OR:0.969; 95%CI:0.943–0.995; P = 0.020] 、 n PP [OR:1.059; 95%CI:0.944–0.974; P <0.010]is related to diabetic nephropathy; the average diastolic blood pressure of 24 hours( 24 h DBP) [OR:1.025; 95%CI:1.006–1.044; P = 0.010] 、 the systolic blood pressure standard deviation of the day(d SSD)[OR:1.055; 95%CI:0.912–1.000; P = 0.049] is related to diabetes peripheral neuropathy. The differences above are all statistically significant(P <0.05).Conclusion: The rise of blood pressure of inpatients with type 2 diabetes mellitus combined with hypertens ion is more common in non-dipper group, and with the patients getting older, their blood pressure variability is greater, the abnormality of blood pressure circadian rhythm is more obvious, which is more likely to cause target organ damage.