BEHAVIOR OF PRESSURE VARIABILITY IN PATIENTS WITH ARTERIAL HYPERTENSION AND DIABETES MELLITUS WITH OR WITHOUT INSULIN USE AND THE INFLUENCE OF THE NUTRITIONAL STATE IN BRAZIL

Abstract

Objective: To evaluate the behavior of systolic and diastolic blood pressure variability through residential measurements in patients with hypertension and diabetes mellitus with or without insulin use associated with nutritional status. Design and method: Cross-sectional study, which evaluated patients undergoing prognosis and/or monitoring of arterial hypertension, who underwent blood pressure examination outside the clinic through telemonitoring by the TeleMRPA platform, between 2015 and 2020, divided into two groups: diabetic hypertensive patients with and without using insulin. Incomplete information and age under 18 and over 100 were excluded. Variables evaluated: body mass index, age, systolic and diastolic blood pressure variability obtained by home blood pressure monitoring, calculated by standard deviation. The results were presented using mean, standard deviation and inferential statistics through the unpaired t-student test, considering a confidence interval of 95% and a significance level of 5%. Results: 57,379 patients with arterial hypertension were selected, of which 2,189 had diabetes mellitus, meeting the criteria, with a mean age of 64.1 (~ 13.02) years for patients with use, and 64.7 (~ 12.26) years for did not use insulin. The body mass index for patients who used insulin was 28.6 (~ 4.57) kg/m2 and for those who did not use it was 29.1 (~ 4.65) kg/m2, without statistical significance (p 0.171). The values of systolic blood pressure variability for patients with and without insulin use were, respectively, 11.1 (~ 4.44) and 10.0 (~ 3.93) with p = 0.0002, and for the variability of diastolic blood pressure, 6.5 (~ 2.94) and 5.9 (~ 2.67) with p = 0.017. Conclusions: In diabetic hypertensive patients, nutritional status was not associated with insulin use. In relation to systolic and diastolic blood pressure variability, there were higher elevations in the group that used insulin. Home blood pressure monitoring is an important alternative for monitoring blood pressure variability, which is a predictor of cardiovascular events in hypertensive and diabetic patients, and can be used reliably through telemonitoring.