IDF21-0455 Pattern of pulse pressure distribution and its determinants in various stages of diabetic nephropathy

Abstract

Background: Pulse pressure (PP) is an indicator of vascular stiffness and is a CV risk determinant. Diabetes is a coronary equivalent. It also multiplies the risk of CKD. With this background, we investigated the distribution and determinants of pulse pressure among diabetic subjects with nephropathy. Aim: The mail aim of this study was to evaluate pattern of pulse pressure distribution and its determinants in various stages of diabetic nephropathy. Method: After obtaining consent from consecutive diabetic subjects visiting Sevayan Diabetes Centre, eGFR was calculated by Cackroft‐Gault formula using serum creatinine. A total of 350 (M/F: 192/158) subjects with eGFR <90 ml/min were selected. BP was recorded 3 times and PP was calculated from the mean values. Based on PP, subjects were divided into 3groups (PP ≤40, 41‐60 and >60 mm Hg). Results: Seventy percent of the participants were hypertensive. Mean values for age, duration of diabetes and PP were 52.5 (95% CI: 51.5–53.5) years, 7.3 (6.7–7.9) years and 52 (50.5–53.5) mm Hg respectively. Nearly 80% of adults aged >50 years had PP more than >40 mm Hg compared to 57% in the younger age group (P = 0.01). Male gender directly influenced PP, which was statistically significant. In subgroup analysis, among CKD stages‐4 and 5 subjects 50% documented PP >60 mm Hg, whereas less than one fourth subjects (23.4%) in stages‐2 and 3 had similar PP measurements (P = 0.01). Progressively increased PP was observed with declining eGFR. Compared to those with diabetes <10 years, subjects with longer diabetes duration had wider PP. Discussion: Declining eGFR, male gender, advanced age and longer diabetes duration were independent risk factors for wide pulse pressure in subjects with diabetic nephropathy.