EFFECTS OF GLYCOSYLATED HEMOGLOBIN LEVEL ON BLOOD PRESSURE VARIABILITY IN HYPERTENSIVE PATIENTS

Abstract

Objective: To investigate the effect of glycosylated hemoglobin (HbA1c) levels on blood pressure variability in hypertensive patients. Design and method: From September 2018 to April 2019, in the Xiangya Hospital of Central South University, 429 case of hypertensive patients with complete basic information, medical records, HbA1c measures and other biochemical indicators, as well as the 24-hour ambulatory blood pressure result were enroll in and divided into two groups (119 in the high HbA1c group with HbA1c more than 6.1 mg/dl and 310 in the normal HbA1c group with HbA1c less than 6.1 mg/dl). The blood variability, night drop rate, and fluctuations were compared between the two groups. Multivariate logistic regression analysis and Pearson correlation analysis were used to explore the relationship between HbA1c level and blood pressure variability. Results: In hypertensive patients, the level of systolic and diastolic pressure during 24-hour, daytime, nighttime and the proportion of non-dipping blood pressure in the high HbA1c group was higher than that in the normal HbA1c group (p < 0.05); There was no significant difference between the two groups in blood pressure load, variability, and nocturnal blood pressure drop rate (p > 0.05).Multivariate logistic regression analysis showed that nocturnal mean systolic blood pressure was a risk factor for increased HbA1c levels, with OR (95% CI) of 1.031 (1.017 to 1.045). Pearson correlation analysis implied that the level of HbA1c was positively correlated with the maximum, the minimum and the average value of 24-hour systolic pressure and mean systolic pressure of daytime and nighttime (r = 0.131, 0.129, 0.155, 0.151, 0.164; p < 0.05). Further analysis of grade 3 hypertensive patients, the high HbA1c group of had the higher value of night systolic pressure load and non-dipping blood pressure ratio. Multivariate logistic regression analysis showed that the mean nocturnal systolic pressure was a risk factor for elevated HbA1c levels, with OR (95% CI) being 3.774 (1.086 to 13.117). Conclusions: HbA1c is closely related to hypertension (especially systolic blood pressure). In the grade 3 hypertensive patients, the elevated HbA1c might increase the value of the nocturnal systolic blood pressure load.