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Hypertensive Diabetic Patients: Casual Pulse Pressure and Ambulatory Blood Pressure Monitoring (ABPM) as Superior

Inês S Pinheiro1, Adriana Pacheco1, Simão Carvalho1

  • 1Internal Medicine, Unidade Local de Saúde da Região de Aveiro, Aveiro, PRT.

Cureus
|February 25, 2025
PubMed

Insights

Hypertensive patients with type 2 diabetes mellitus face worse survival outcomes. Ambulatory blood pressure monitoring revealed elevated pulse pressure and resistant hypertension are linked to poorer prognosis in these individuals.

Area of Science:

  • Cardiology
  • Endocrinology
  • Hypertension Research

Background:

  • Type 2 diabetes mellitus (T2DM) significantly increases cardiovascular risk in hypertensive (HTN) patients.
  • Diabetic individuals with HTN experience poorer survival outcomes compared to non-diabetic counterparts.
  • Limited research exists on the prognostic value of ambulatory blood pressure monitoring (ABPM) specifically within diabetic hypertensive populations.

Purpose of the Study:

  • To retrospectively assess the prognostic significance of ABPM in hypertensive patients with T2DM.
  • To investigate the association between ABPM-derived blood pressure parameters and survival outcomes in diabetic HTN patients.
  • To explore the prevalence and impact of resistant hypertension (RH) in this specific patient subgroup.

Main Methods:

  • Retrospective analysis of 823 hypertensive patients (240 diabetic, 583 non-diabetic) with long-term follow-up (11.8 ± 5.6 years).
  • ABPM performed using a SpaceLabs 90207 device during a typical workday.
  • Statistical analysis using IBM SPSS Statistics to compare outcomes between diabetic and non-diabetic groups, examining pulse pressure and RH.

Main Results:

  • Hypertensive patients with T2DM exhibited significantly higher rates of severe cardiovascular events, heart failure, and mortality.
  • Elevated pulse pressure (PP) on ABPM was independently associated with worse survival outcomes.
  • Resistant hypertension (RH) was more prevalent in the diabetic group and linked to poorer survival.

Conclusions:

  • Hypertensive patients with T2DM face a substantially increased risk of adverse cardiovascular events and mortality.
  • ABPM-derived elevated pulse pressure and the presence of resistant hypertension are critical indicators of poor prognosis in diabetic hypertensive patients.
  • These findings underscore the importance of ABPM in managing hypertensive individuals with T2DM to tailor therapeutic strategies and improve survival.

Keywords:
ambulatory blood pressure monitoringcardiovascular eventsdiabeteshypertensionpulse pressure

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