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Central Hemodynamic Parameters of Controlled hypertensive Patients with Diabetes
제주대학교병원
현소영, 강동구,배재석,김송이,김기석,주승재
Objectives: Although diabetes is a major risk for atherosclerosis, there was not known regarding the relationship between diabetes and central hemodynamic parameters in hypertensive patients. The aim of this study is analysis of central hemodynamic parameters in controlled hypertensive patients with diabetes. Methods: We recruited 547 hypertensive patients who came to our cardiovascular outpatient facility from June, first, to July, first, 2010 and we selected 368 patients with controlled blood pressure(diabetes and chronic kidney disease ≤130/80 mmHg, non-diabetes and non-chronic kidney disease ≤140/90mmHg). Subjects were composed of 202 males and 166 females. We obtained radial arterial wave from radial tonometry(HEM9000-AI) and analyzed peripheral systolic blood pressure, systolic blood pressure 2(SBP2), peripheral augmentation index(pAI), peripheral augmentation index75(pAI75), systolic blood pressure1-systolic blood pressure2 and central pulse wave(cPP) according to the diabetes. Results: 1. SBP2, pAI75 and cPP showed insignificant difference according to the diabetes in all hypertensive patients(N=547). 2. In univariate and multivariate analysis, SBP2 and AI were significantly lower and SBP1-SBP2 was higher in diabetic patients with controlled hypertension than in non-diabetic patients. 3. The medication of B-blocker and ACEI were different between in diabetic and non-diabetic patients with controlled hypertension. Conclusions: Results indicate that tight peripheral blood pressure control would be effective in reducing the central hemodynamic parameters related to cardiovascular events in diabetic patients with hypertension.

Variables

 

Diabetes(n=64)

 mean±SD

 

Non-diabetes(n=304)

mean±SD

p value

Age(year)

67.3±11.3

 

65.9±11.3

 

0.363

Sex

 

M:37(57.8%)

F:27(42.2%)

 

M:165(54.3%)

F:139(45.7%)

 0.605

Smoking

 

7(10.9%)

 

46(15.2%)

0.380

Coronary heart disease

 

23(35.9%)

 

84(27.6%)

0.184

Chronic kidney disease

 

9(14.1%)

 

12(3.9%)

0.002

Heart rate(/min)

71.9±13.1

 

67.7±10.7

 

0.023

SBP1(mmHg)

118.3±8.4

 

122.2±10.4

 

0.002

SBP2(mmHg)

105.0±15.8

 

113.2±13.0

 

0.000

pAugmentation index(%)

78.5±12.8

 

85.2±13.2

 

0.000

pAugmentation ndex75(%)

77.7±12.4

 

84.7±43.0

 

0.208

SBP1- SBP2(mmHg)

13.3±13.5

 

9.0±8.1

 

0.001

Central Pulse Pressure(mmHg)

38.48±15.7

 

42.8±12.0

 

0.014



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