ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 GP29 | DOI: 10.1530/endoabs.63.GP29

Systematic screening of masked hypertension in normotensive type 2 diabetic patients

Dorra Ghorbel1, Faten Hadjkacem1, Faten Triki2, Mouna Mnif1, Nadia Charfi1, Nabila Rekik1, Samir Kammoun2 & Mohamed Abid1

1Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia; 2Cardiology Department, CHU Hédi Chaker, Sfax, Tunisia.

Introduction: Masked hypertension (MH) is a relatively recent description leading to a similar cardiovascular risk as permanent hypertension. Masked hypertension is more common among diabetic patients.

Methods: This was a case-control study. We performed 24-hour ambulatory BP in 53 type 2 diabetic patients normotensive in clinical measurement. We compared both Masked Hypertension and Normotensive groups according to clinical/laboratory parameters and target organ damage, and identify MH predictor risk factors among diabetic population.

Results: We recruited 53 patients whose mean age was 55.3±8.4 years (range 35–72 years) with a sex ratio (H/F) equal to 0.89. The mean age of diabetes was 8.7±3.9 years with extremes between 2 and 17 years old. The mean BMI of our patients was 28.2±5.3 kg/m2. Overweight was found in almost half of our patients (47.2%). Obesity was found in 32.1% of cases. Metabolic syndrome was found in 64.2% of patients. In our study, the prevalence of HTAM in type 2 diabetics was 64%. Our study also found that this HTAM was more often nocturnal (58.5%), occurred in predominantly non-dippers. Left ventricular hypertrophy, microalbuminuria and documented arterial stiffness by pulsed pressure greater than 60mm Hg in were more common in the group of HTAM. For the predictive factors of HTAM, we were able to collect in univariate analysis the factors age of diabetes, fasting blood glucose, body weight and microalbuminuria. In multivariate analysis, the predictive factors that emerged in our study are: the bad glycemic control (HbA1c ≥7%), elevated BMI and duration of diabetes.

Conclusion: The masked hypertension should be evaluated in diabetic patients because it helps to better assess cardiovascular risk in particular by identifying affected target organs.

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