Ambulatory blood pressure parameters in antihypertensive drug-naïve subjects with prediabetes

Abstract

The aim of this study was to evaluate ambulatory blood pressure characteristics in subjects with prediabetes who have not been treated with antihypertensive drugs. The assessment was not only targeting undiagnosed hypertension but also the “white-coat” hypertension (WCH), masked hypertension (MaskH) and abnormal circadian blood pressure patterns (non-dippers, extreme dippers). One hundred and twenty subjects (56 males, 64 females), of mean age 44.72 ± 12.49 years, were included in the study. After evaluation of glucose tolerance the participants were divided into two groups: Group 1 – subjects with prediabetes; and Group 2 (Control group) – subjects with normal glucose tolerance (NormGT). All participants were without previously diagnosed hypertension and had never received any antihypertensive drug. Standard anthropometric parameters – weight, height and waist circumference, were measured in all subjects. Blood pressure was measured by ambulatory blood pressure monitoring. No significant differences in the anthropometric parameters have been observed. The ambulatory blood pressure monitoring identified higher prevalence of undiagnosed hypertension among the subjects with prediabetes (52.17% vs 43.24% in the control group). The prevalence of masked hypertension was lower among the subjects with prediabetes (13.33%), compared to NormGT (28.88%). For WCH the prevalence in prediabetes (27.27%) was slightly lower than in the control group (34.48%). The analysis of the circadian pattern of ambulatory blood pressure demonstrated higher prevalence of “non-dippers” in the group with prediabetes (36.96% vs 28.38%), while the prevalence of “extreme dippers” was close to that of the control group (8.69% vs 9.46%). The high prevalence of undiagnosed hypertension among subjects with prediabetes suggests that ambulatory blood pressure monitoring could be used on a regular basis in the evaluation of subjects with prediabetes considered normotensive. The method could also be important to identify “non-dippers” as the prevalence of this pattern tends to be higher in prediabetes.