Ambulatory Blood Pressure Monitoring as a Useful Tool in the Cardiological Assessment of Pancreas Transplant Recipients with Type 1 Diabetes

Abstract

Having the appropriate tools to identify pancreas recipients most susceptible to coronary artery disease (CAD) is crucial for pretransplant cardiological assessment. The aim of this study is to evaluate the association between blood pressure (BP) indices provided by ambulatory blood pressure monitoring (ABPM) and the prevalence of CAD in pancreas transplant candidates with type 1 diabetes (T1D). This prospective cross-sectional study included adult T1D patients referred for pretransplant cardiological assessment in our center. The study population included 86 participants with a median age of 40 (35–46) years. In multivariate logistic regression analyses, after adjusting for potential confounding factors, higher 24 h BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.063, 95% CI 1.023–1.105, p = 0.002/OR = 1.075, 95% CI 1.003–1.153, p = 0.042/OR = 1.091, 95 CI 1.037–1.147, p = 0.001, respectively) and higher daytime BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.069, 95% CI 1.027–1.113, p = 0.001/OR = 1.077, 95% CI 1.002–1.157, p = 0.043/OR = 1.11, 95% CI 1.051–1.172, p = 0.0002, respectively) were independently and significantly associated with the prevalence of CAD. Daytime pulse pressure was the strongest indicator of the prevalence of CAD among all analyzed ABPM parameters. ABPM can be used as a valuable tool to identify pancreas recipients who are most susceptible to CAD. We suggest the inclusion of ABPM in pretransplant cardiac screening in type 1 diabetes patients eligible for pancreas transplantation.

Keywords

• type 1 diabetes
• hypertension
• ABPM
• pancreas transplantation
• pancreas–kidney transplantation
• coronary artery disease