Impact of high normal blood pressure on atherosclerosb in type 2 diabetes

Abstract

Objective To evaluate the impact of high normal blood pressure (BP) level atherosclerosis in type 2 diabetic patients. Methods Nine hundred and thirty outpatients with type 2 diabetes were recruited in Ruijin Hospital and allocated into normotensive(n= 167), high normal BP(n= 213) and hypertensive(n =550)groups based on blood pressure levels. Maximum intima-media thickness (IMT) of carotid arteries and brachial-ankle pulse-wave velocity (baPWV)were measured to assess atberosclerosis. Results Subjects with hypertension and high normal BP were with significantly greater maximum IMT and baPWV as compared to those with normal BP. Multiple logistic regression analysis revealed that high normal BP was a significant independent determinant factor of atherosclerosis(maximum IMT≥1.1 mm: OR 2. 10,95% CI 1.28-3.44; baPWV≥ 1 400 cm/s: OR 3.09, 95% CI 1. 78-5. 36).Conclusion High normal BP is a significant determinant factor of atherosclerosis independent of conventional cardiovascular risk factors in type 2 diabetic patients. Maintenance of systolic BP<120 mm Hg(1 mm Hg=0.133 kPa) and diastolic BP<80 mm Hg may reduce the risk of atherosclerosis in type 2 diabetes. Key words: Blood pressure; Diabetes mellitus, type 2; Atherosclerosis; Intima-media thickness; Brachial-ankle pulse-wave velocity