The ambulatory blood pressure monitoring among obese and nonobese diabetes mellitus patients

Abstract

Background: Obesity and diabetes mellitus are two major factors related with the risk of metabolic syndrome and cardiovascular diseases. Co-existing hypertension with diabetes mellitus and obesity has poor prognosis for cardiovascular diseases. Ambulatory blood pressure monitoring (ABPM) correlates more closely to target organ damage than clinic blood pressure. Objectives: The objective of the study is to assess and compare ABPM pattern among obese and nonobese diabetes mellitus patients. Materials and Methods: A cross-sectional study was conducted among fifty obese and fifty nonobese diabetic patients who were classified based on their body mass index as per the WHO criterion. The clinical blood pressure measurements were measured on each subject using a digital sphygmomanometer, and 24 h ABPM was done and ABPM parameters such as dipping pattern, 24 h systolic blood pressure (SBP), diastolic blood pressure (DBP), Mean SBP, mean DBP, diurnal variability of SBP, DBP, Mean arterial pressure, pulse pressure, SD systole (Standard Deviation systole), SD diastole, white coat hypertension was derived and compared between the two groups. Results: Around 37 (74%) obese and 18 (36%) nonobese showed non dipping pattern in SBP and 28 (66.7%) of obese and 14 (33.3%) of nonobese showed a nondipping pattern in DBP and was found to be statistically significant ( P < 0.001). On comparison between normotensive obese and normotensive nonobese, it was found that SBP non dipping pattern18 (67%) versus 9 (29%) and DBP nondipping pattern 12 (45%) versus 5 (16%) was statistically significant with P = 0.004, 0.016, respectively. Conclusion: Obese diabetes mellitus subjects had altered ABPM parameters and increased prevalence of nondipping status. In addition, obese diabetic patients who did not give prior history of hypertension were also found to have higher nondipping SBP and DBP patterns.

Obesity in Hypertensive Patients Is Characterized by a Dawn Phenomenon in Systolic Blood Pressure Values and Variability

“…Conversely, among participants with coexisting hypertension and diabetes, no significant difference was observed in nocturnal SBP values, regardless of obesity status. When categorizing participants based on BMI values (above 25 and below 25), Mathews et al demonstrated elevated diurnal systolic blood pressure variability (calculated as standard deviation > 10 mm Hg) among obese subjects, with no statistically significant difference noted in diastolic blood pressure variability within these same groups [20]. Palatini et al also reported a relationship between the BMI of untreated hypertensive participants and the variability in the systolic and DBP during the night [26].…”

“…Furthermore, another study emphasized that obesity plays a crucial role in influencing ABPM values, affecting not only individuals with hypertension but also those with conditions like diabetes. In their study, Mathews et al revealed that individuals with both obesity and diabetes mellitus exhibited significant circadian variations in blood pressure parameters and an elevated prevalence of non-dipping status [20]. Our study aimed to evaluate the differences in the short-term blood pressure variability profile in both treated and drug-naive individuals with essential hypertension in different categories of obesity.…”