Definition of the relationships between ambulatory blood pressure characteristics and blood glucose levels in type 2 diabetes patients with well-controlled arterial hypertension
Arterial hypertension is the most common comorbidity in patients with type 2 diabetes mellitus (T2DM). The combined effects of hyperglycemia and elevated blood pressure (BP) may increase the risk of macro- and microvascular complications. This study aimed to investigate BP characteristics over a 24-hour period and to evaluate the relationship between continuous glucose monitoring (CGM) parameters and ambulatory BP monitoring (ABPM) indicators in T2DM patients with well-controlled BP. 53 T2DM patients and 10 controls were examined. All subjects were conducted with CGM and ABPM. Disturbances of BP circadian rhythm were observed in 81.1% of patients. Compared with controls, the patients with T2DM had significantly higher average daily systolic BP, diastolic BP and pulse BP and their variabilities. Glucose variability, together with hypoglycemia, affects the ABPM indicators and determines them by 60.55%, with the greatest impact on the systolic pressure area index and systolic pressure time index (R=0.82 (χ²=261.76; p=0.001). Thus, the patients with T2DM and well-controlled arterial hypertension have disturbances in circadian BP rhythm with the predominance of “non-dipper” and the appearance of “night-peaker” patterns. We indicated a strong significant relationship between systolic BP load indicators and high glucose variability together with hypoglycemia.