Endocrine Abstracts

Background: The association between isolated office hypertension (IOH) and masked hypertension (MH) with left ventricular hypertrophy (LVH) and diastolic dysfunction cannot be the same, determining different increased cardiovascular risk.

Aims: To evaluate the prevalence of MH and IOH in treated hypertensive patients with type 2 diabetes and their association with LVH and diastolic dysfunction.

Methods: A cross-sectional study was conducted in 193 consecutively selected hypertensive patients with type 2 diabetes, at the outpatient clinic of a hospital in Southern Brazil. Patients performed an evaluation with office blood pressure (BP), 24-h ambulatory BP monitoring (ABPM) and echocardiography. They were classified according to their BP control (office:<140/90 or ≥140/90 mmHg; daytime ABPM:≤130/85 or >130/85 mmHg) in controlled hypertension (CH: low office BP, low ABPM), IOH (high office BP, low ABPM), MH (low office BP, high ABPM), and truly uncontrolled hypertension (TUH: high office BP, high ABPM).

Results: Seventy patients were men, mean age 56.8±6 years, HbA1c 8.1±1.9%, diabetes duration 11.9±8.8 years, of which 19.7%, 15.5%, 24.4%, and 40.4% were identified as having CH, IOH, MH and TUH, respectively. Interventricular septum was 0.98±0.21, 0.95±0.15, 1.04±0.17 and 1.03±0.16 mm in CH, IOH, MH and TUH, respectively, P=0.05. The posterior wall thickness was 0.91±0.14, 0.90±0.13, 0.98±0.13 and 0.99±0.15 mm in CH, IOH, MH and TUH, respectively, P=0.004. In a logistic regression model using body mass index and age as covariates, LVH (septum>1 mm) was not associated with IOH (OR 0.53, CI 0.19–1.51, P=0.241) or MH (OR 1.70, CI 0.683–4.23, P=0.254). Diastolic dysfunction did not differ among groups.

Conclusions: The prevalence of MH and IOH was lower than estimated in the literature in diabetic patients. Masked hypertension and TUH seem to be similar entities with respect to their effects on hypertrophy parameters, while IOH would be a more benign condition.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.