Glycemic Parameters in Relation to Pulse Pressure in Patients with Type 2 Diabetes Mellitus

Aims: Pulse pressure (PP) is determined by the complex relationship between stroke volume of the heart, aortic elasticity and peripheral vascular resistance. PP has been considered an independent risk factor for cardiovascular mortality of normotensive and hypertensive individuals. The aim of this study was to determine the prevalence of hypertension (HT) in patients with Type 2 diabetes mellitus (DM) and to evaluate the relationship between glycemic parameters and PP.

Methodology: A total of 422 patients with type 2 DM, mean age 58.0±13.2 years, were included in the study. Data on patient demographics, blood pressure and PP readings ​​were recorded in each patient as were the glycemic parameters including fasting blood glucose (FBG), postprandial blood glucose (PPBG) and HbA1c. Glycemic parameters were also evaluated with respect to PP groups. The patients were divided into 4 groups according to the PP readings including group 1 (PP ≤45 mmHg), group 2 (PP:46-54 mmHg), group 3 (PP:55-64 mmHg) and group 4 (PP ≥65 mmHg).

Results: Hypertension was evident in 79.6% of patients. Mean PP was 55.3±12.5mmHg. While group 1 and 2 were similar in terms of glycemic parameters, FBG (p=0.026), PPBG (p=0.019) and HbA1c (%) (p=0.004) were significantly lower than group 3 and group 4 (p< .05).

Conclusions: Our findings revealed HT at a high frequency of 79.6% in patients with Type 2 DM. Significant highest values were found for FBG, PPBG and HbA1c in high PP patients. These results may be associated with increased cardiovascular risk in patients with poor glycemic control with Type 2 DM and high PP. In order to reduce the pulse pressure in diabetic patients, it will be appropriate to keep blood pressure at target values besides strict blood glycemic control.