Our aim was to evaluate a possible negative influence of the presence of Type 2 Diabetes mellitus (T2DM) on 24 h. ambulatory blood pressure monitoring (ABPM) pattern, vascular risk profile and severity of left ventricular (LV) function in patients with Acute Heart Failure (AHF).
Methods: In 184 patients with AHF we compare clinical features of 64 (65±9 years / 87,5% males) with T2DM versus 120 (63±11 years / 68,3% males) non-T2DM.
In addition to clinical examination and analytical parameters, all patients underwent a 24 h, ABPM and echocardiogram and evaluation of degree of severity LV Dysfunction.
Patients with T2DM had higher (p <0.001) prevalence (%) of Hypertension (75 vs 46.7), dyslipidemia (65.6 vs 28.3), obesity (47 vs 43), and worse renal function (fGe: 64.7 vs 72.3 ml/min/1.75m2). Etiology IC: Hypertensive and/or ischemic heart disease: 75% vs 60%. Mean Values of 24 h ABPM measurements are in table 1.
No significant differences in diastolic blood presure (DBP) between groups, but patient with T2DM present higher average values (p <0.05) of SBP 24h (mmHg): 116/111); daytime (117/112) and nightime (114/108); higher 24 h Pulse Pressure (50 vs 46mmHg) and non-dipper pattern frequency (84.7 vs 79.35), as well as a greater proportion of patients with moderate/severe LV dysfunction (87.6 vs 81.7%) (p <0 , 05).
We also observed worse NYHA functional class in T2DM patients: NYHA II-III 84,4 vs 58,3%, p< 0,001.
In patients with AHF, the presence of T2DM contributes to show greater hypertensive and/or ischaemic ethiology, further deterioration of 24 h ABPM pattern and worse left ventricular myocardial function.
T2DM can be considered as a risk factor and worsening of heart failure. 24h ABPM may contibute to a better prognostic evaluation in these patients.