Morning arterial hypertension and its relationship with cardiovascular risk in diabetic patients
Keywords:
hypertension, diabetes mellitus, ambulatory blood pressure monitoring, circadian blood pressure cycle, morning hypertension, non-dipper, nocturnal arterial hypertension.Abstract
Introduction: Diabetes mellitus is an independent risk factor for cardiovascular disease. The coexistence with morning hypertension stresses the potential risk.
Objetive: The aim of this study was to assess morning hypertension as a cardiovascular risk factor in hypertensive diabetic patients.
Methods: A descriptive, cross-sectional, retrospective study of a database on 24-hour ambulatory blood pressure monitoring was carried out at the "Hermanos Ameijeiras" Hospital between 2010 and 2020.
Results: Of the total number of patients studied (n=5937), 782 were diabetic with (n=307) or without (n=475) morning hypertension, respectively. When compared with the classification of circadian patterns, 143 (46.6%) non-dipper vs. 191 (40.2%), inverse dipper 51 (16.6) vs. 64 (13.5%), accentuated dipper 23 (7.5%) vs. 33 (6.9) respectively. Diabetic individuals with morning hypertension and abnormal circadian parameters did not have 24-hour hypertension 114 (37.1%), nocturnal hypertension had a significant frequency (n=1295), 61% of the total number of patients.
Conclusions: Research demonstrates the importance of identifying morning hypertension and other abnormal circadian blood pressure parameters in all high-risk patients and especially in all hypertensive diabetics. Ambulatory monitoring is the precise and rational indication that must be made at some point in its development to stratify cardiovascular risk, including the use of prognostic circadian indices, having accurate circadian measurements and being able to project intervention strategies closer to the patient's reality.
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