Levels of blood pressure and blood glucose in elderly patients with hypertension and diabetes: association with carotid atherosclerosis

Abstract

To explore the association between blood pressure and blood glucose levels and carotid atherosclerosis in elderly patients with essential hypertension and type 2 diabetes mellitus (T2DM). A total of 670 patients aged 60 years or over with hypertension and T2DM were recruited and categorized by their systolic blood pressure (SBP): tight control, < 130 mm Hg, usual control, 130 - 139 mm Hg, or uncontrolled, ≥ 140 mm Hg; and by their HbA1c level: tight control < 6.5%, usual control 6.5% - 7.5%, or uncontrolled, ≥ 7.5% respectively. Carotid ultrasonography was performed in all subjects for the evaluations of intima-media thickness (IMT) and plaque. Multiple linear regression analyses revealed that IMT was positively correlated with SBP (β = 0.215, P = 0.002) and HbA1c (β = 0.149, P = 0.031), whereas IMT was negatively correlated with high-density lipoprotein cholesterol (β = -0.196, P = 0.002). According to the multivariate logistic regression analysis, SBP ≥ 140 mm Hg (OR = 1.473, 95%CI 1.044 - 2.078 P = 0.027), HbA1c ≥ 7.5% (OR = 1.445, 95%CI 1.031 - 2.027, P = 0.033) and total cholesterol (OR = 1.014, 95%CI 1.004 - 1.024, P = 0.019) were significant risk factors for carotid artery atherosclerotic plaques whereas high-density lipoprotein cholesterol (OR = 0.895, 95%CI 0.805 - 0.994, P = 0.012) was a protective factor for carotid artery atherosclerotic plaques in elderly patients with hypertension and T2DM. There is a significant correlation between the levels of blood pressure, blood glucose and carotid atherosclerosis in elderly patients.