P151 CENTRAL PULSE PRESSURE IS ASSOCIATED WITH AORTIC-BRACHIAL STIFFNESS MISMATCH IN PATIENTS WITH ARTERIAL HYPERTENSION AND DIABETES MELLITUS

Abstract

Background: Central pulse pressure (PP) is a surrogate measure of arterial stiffness (AS) and a predictor of cardiovascular events in type 2 diabetes mellitus (T2DM). AS gradient reflects the vascular ageing. The aim of the study: To evaluate the associations between 24-h central PP and parameters of AS in patients with arterial hypertension (AH) and T2DM. Materials and methods: 90 patients with AH and T2DM were included (39%males, mean age 63,8±11,6). Mean office BP was 146±23/86±10 mmHg. Median duration of DM was 8,5 years. 24- h peripheral and central BP monitoring was performed (BPLab Vasotens). AS parameters were assessed by applanation tonometry (Sphygmocor, AtCor). AS gradient was calculated as cfPWV/crPWV and its elevation ≥1 was considered as AS mismatch. р < 0,05 was considered significant. Results: Mean central BP was 132±18/79±12 mmHg, cfPWV–10, 5±2,4 m/s, crPWV– 8, 5±1,4m/s, AS gradient–1,2±0, 3. 24-h central BP levels were as follows: 132±18/79±12 mmHg for 24hBP, 132±18/81±13 mmHg for daytime and 129±20/75±11 mmHg for nighttime. Mean PP levels were 53±14, 52±14 and 56±15 mmHg, respectively. 24-h central PP increase > 50 mmHg was observed in 30% patients. These patients were older (67,1±10,5 vs 61,8±11,9 years), had higher median duration of DM (10; IQR 7–15 vs 5; IQR 0, 9–12 years), cfPWV (11,4±1,9 vs 10,0±2,6 m/s) and stiffness gradient (1,4±0,3 vs 1,2±0,2), p < 0,05 for trend. There were significant correlations between 24-h central PP and age (r = 0,27) and AS gradient (r = 0,32), p < 0,05 for trend. No predictors of PP elevation were found. Conclusions: In diabetic patients with AH increase of central PP is associated with aortic-brachial stiffness mismatch. This finding confirms its importance as a marker of vascular ageing in this patient population.