■约50%的2型糖尿病(T2D)和高血压患者在睡眠期间血压下降不到10%,与更频繁的心血管并发症和保留预后相关的模式。这项研究分析了与不同北斗星轮廓相关的预测风险因素,尤其是夜间活动模式,在平均动脉压(MAP)之后,平均心率(MHR),T2D和高血压患者的平均脉压(MPP),通过动态血压监测(ABPM)建立。
■166名连续的2型糖尿病和高血压患者被纳入一项横断面研究,他们接受了24小时ABPM。我们排除了继发性高血压患者,急性冠状动脉疾病和心力衰竭,患有肿瘤或内分泌疾病。进行了简单和多元线性回归模型预测24小时,白天和黑夜的地图,MHR,和MPP根据各种预测因子,使用软件R版本4.3.1。
■有80种非浸渍剂(48.20%),57剂(34.34%),22个反向浸渍者(13.25%)和7个极端浸渍者(4.21%)。在24小时MAP和总胆固醇(TC)之间观察到统计学上的显着关联(较高的TC值与较高的MAP/24小时值相关):回归斜率的调整系数B:0.09,95%置信区间CI(0.04-0.15),p=0.003。在多变量分析中:调整后的B:8.64,95%CI(-14.67-2.61),p=0.006,β受体阻滞剂达到与MHR/24h相关的统计学意义阈值,他们的存在降低了心率。在多变量分析中,PP/24小时与年龄相关:调整后的B:0.45,95%CI(0.05-0.85),p=0.28;腹围:0.26,95%CI(0.03-0.49),p=0.028,总胆固醇:0.1,95%CI(0.02-0.17),p=0.013。糖尿病肾病与PP/24h有统计学意义:调整后的B:10.19,95%CI(1.24-19.14),p=0.027。
■高胆固醇与较高的MAP和PP值相关。β受体阻滞剂治疗降低了非北斗星MHR。年龄和AC与PP值增加相关。这些是与ABPM确定的非浸渍者状态相关的预测性风险因素,它们代表了T2D和高血压患者的非北斗型模式的名副其实的联系。
UNASSIGNED: The non-dipper status represented by blood pressure reduction by less than 10 percent during sleep is present in about 50 percent of patients with type 2 diabetes (T2D) and hypertension, a pattern associated with more frequent cardiovascular complications and reserved prognosis. This study analyzed the predictive risk factors associated with the different dipper profiles, especially with the nocturnal pattern, following the mean arterial pressure (MAP), the mean heart rate (MHR), and the mean pulse pressure (MPP) in patients with T2D and hypertension, established by ambulatory blood pressure monitoring (ABPM).
UNASSIGNED: 166 consecutive patients with type 2 diabetes mellitus and hypertension were included in a cross-sectional study, and they underwent 24-hour ABPM. We excluded patients with secondary hypertension, acute coronary disease and heart failure, with oncologic or endocrine disease. The simple and multiple linear regression models were performed predicting 24-hour, day and night MAP, MHR, and MPP according to various predictors, using software R version 4.3.1.
UNASSIGNED: There were 80 non-dippers (48.20%), 57 dippers (34.34%), 22 reverse-dippers (13.25%) and seven extreme-dippers (4.21%). A statistically significant association was observed between MAP 24-hour and total cholesterol (TC) (higher TC values were associated with higher MAP /24 h values): adjusted coefficient B of the regression slope: 0.09, 95% confidence interval CI (0.04-0.15), p=0.003. In the multivariate analysis: adjusted B: 8.64, 95% CI (-14.67-2.61), p=0.006, beta-blockers reached the threshold of statistical significance in relation to MHR/24 h, their presence decreasing the heart rate. PP/24 hours was associated in the multivariate analysis with age: adjusted B: 0.45, 95% CI (0.05-0.85), p=0.28; abdominal circumference: 0.26, 95% CI (0.03-0.49), p=0.028, and total cholesterol: 0.1, 95% CI (0.02-0.17), p=0.013. Diabetic nephropathy was statistically significantly associated with PP/24 h: adjusted B: 10.19, 95% CI (1.24-19.14), p=0.027.
UNASSIGNED: High cholesterol was associated with higher values of MAP and PP. Beta-blocker treatment lowered non-dipper MHR. Age and AC were correlated with increased PP values. These are predictive risk factors associated with the status of non-dippers established by ABPM, and they represent a veritable link to the non-dipper pattern in patients with T2D and hypertension.