Prevelance Of Masked Hypertension İn Type 2 Diabetic Patients And Correlation With Hba1 C Levels

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Introduction

Hypertension is a significant health problem due to its very high prevalence and associated risks of cardiovascular, cerebrovascular and renal complications (1) In a significant number of patients control of hypertension is difficult,in spite of effective therapy strategies (2,3). Pickering et al.(4) first determined the phenomenon of masked hypertension (MH) to describe the clinical condition of patients with elevated ambulatory blood pressure (ABP) but normal clinical blood pressure(CBP). Most of these patients were not aware of their blood pressure status and so were not receiving antihypertensive therapy (4). These MHT patients presented with target organ damages, as albuminuria and left ventricular hypertrophy. Indeed, cardiovascular disease risk is even higher in MH patients than in essential hypertensive patients.(4). MHT is a public health concern with the confluence of increased CVD risk, a failure to be diagnosed by the conventional approach of blood pressure measurement in the clinic setting, and relatively high prevalence (5,6,7,8). According to the landmark SHEAF study patients with MH are at increased risk of developing sustained hypertension (9,10).
Masked hypertension (MHT) is clinically defined in non-diabetics as an office blood pressure (BP) levels lower than 140/90 mmHg and daytime BP > 135/85 using ambulatory BP monitoring (ABPM),and in those with diabetes as a OBP <130/80 mmHg and a ABPM >125/75 mmHg (11). The prevalence of MHT is accepted as 8-10% among the general population. Among the diabetic population masked hypertension prevalance is increased about two to six times in comparison to general population. In the current literature, MHT is associated with increased macrovascular and microvascular complications in patients with DM population (12) MH is associated with other cardiovascular risk factors such as diabetes, and in non-diabetics, with male sex, older age and obesity (11). 24 h ABPM application is in use for diagnosis of masked hypertension in susceptible patients (12)
The aim of this study was to determine the prevalence and determinants of masked hypertension in diabetic patients and evaluate the relationship between HbA1c and MHT in diabetic patients.

Methods

Study population : All the participants were diagnosed with T2DM. A total of 80 T2DM outpatients admitted to our hospital from December 2011 to December 2012 were enrolled in this study. None of the participants were using antihypertensive medications. ABPM for 24 h was obtained in all patients whose office BP was below 130/80 mmHg.
HbA1c levels were measured in all patients. The cohort was composed of 36 males (%45) and 44 females (%55) between 30 and 80 years old. Our exclusion criteria were as follows; prior hypertension diagnosis, use of medications for hypertension and hyperlipidemia,hypertrophic cardiomyopathy or other structural cardiac disease, office BP measurement of >130/80 mmHg
Ethical clearance: This project has been approved...

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