Features of isolated systolic and resistant arterial hypertension in patients with type 2 diabetes mellitus
- Authors: Ignatenko G.A.1, Bagriy A.E.1, Prikolota A.V.1, Prikolota O.A.1, Mikhailichenko E.S.1, Arshavskaya I.A.1, Kotova K.A.1
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Affiliations:
- M. Gorky Donetsk State Medical University, Ministry of Health of Russia
- Issue: Vol 35, No 12 (2024)
- Pages: 80-85
- Section: From Practice
- URL: https://journals.eco-vector.com/0236-3054/article/view/677660
- DOI: https://doi.org/10.29296/25877305-2024-12-15
- ID: 677660
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Abstract
Hypertension and type 2 diabetes mellitus (DM) are often combined and mutually enhance the adverse effects on vascular and renal prognosis. One of the features of hypertension in type 2 diabetes is the frequent occurrence of isolated systolic hypertension (ISG) and resistant hypertension (RH).
Objective. To study the features of the structure and function of the left ventricle (LV), categories of circadian rhythm during outpatient blood pressure monitoring (OBPM), as well as the structure and function of blood vessels in people with type 2 diabetes, depending on the presence or absence of ISG and RH.
Materials and methods. An observational descriptive one-step study was conducted 139 patients with hypertension in combination with type 2 diabetes (64 men and 75 women aged 73.9±11.7 years). ISAG was isolated if systolic blood pressure (BP) exceeded 140 mmHg, and diastolic blood pressure was less than 90 mmHg. RH was determined if, despite lifestyle changes and taking three classes of antihypertensive drugs, it was not possible to achieve target blood pressure levels. All patients underwent OBPM, echocardiography, ultrasound examination of the brachiocephalic arteries and a reactive hyperemia test.
Results. Among 139 patients with hypertension in combination with type 2 DM, systolic-diastolic hypertension was present in 80 (57.6%) cases, ISG in 59 (42.4%), RH in 57 (41.0%), hypertension without resistance to antihypertensive treatment in 82 (59.0%).
Conclusions. Patients with ISG characterized by more pronounced and eccentric LV hypertrophy (LVH), types II and III of LV diastolic dysfunction (DD), the "non-dipper" category in OBPM, as well as a significant thickening of the intima-media complex (IMC) of the common carotid artery (CCA). Patients with RH characterized by more pronounced and concentric LVH, types II and III of LV DD, the "night-peaker" category in OBPM, significant thickening of the IMC CCA and impaired brachial artery response in the reactive hyperemia test.
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About the authors
G. A. Ignatenko
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Author for correspondence.
Email: prikav@yandex.ru
ORCID iD: 0000-0003-0562-3509
Professor, MD
Russian FederationA. E. Bagriy
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Email: prikav@yandex.ru
ORCID iD: 0000-0002-0295-3724
Professor, MD
Russian FederationA. V. Prikolota
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Email: prikav@yandex.ru
ORCID iD: 0000-0002-9128-2511
Candidate of Medical Sciences
Russian FederationO. A. Prikolota
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Email: prikav@yandex.ru
ORCID iD: 0000-0002-2127-6925
Candidate of Medical Sciences
Russian FederationE. S. Mikhailichenko
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Email: prikav@yandex.ru
ORCID iD: 0000-0001-8625-1406
Candidate of Medical Sciences
Russian FederationI. A. Arshavskaya
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Email: prikav@yandex.ru
ORCID iD: 0000-0002-5839-1409
Candidate of Medical Sciences
Russian FederationK. A. Kotova
M. Gorky Donetsk State Medical University, Ministry of Health of Russia
Email: prikav@yandex.ru
ORCID iD: 0000-0002-1268-7722
Russian Federation
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