Key result
Elevated 24-hour SBP ≥130 mmHg linked to ~114% higher carotid plaque risk in T2D.
Why the study?
ABPM is widely used in diabetes for cardiovascular risk assessment, but its link to early atherosclerosis, such as carotid plaques, is less clear.
Is elevated ambulatory systolic blood pressure associated with carotid plaques in patients with type 2 diabetes, and does glycemic control modify this risk?
Cross-Sectional (n=498)
No
Is elevated ambulatory systolic blood pressure associated with carotid plaques in patients with type 2 diabetes, and does glycemic control modify this risk?
Elevated ambulatory systolic blood pressure is independently associated with carotid atherosclerosis specifically in patients with poorly controlled type 2 diabetes (HbA1c ≥ 6.4%).
Answers are grounded in this paper and cite their sources.
Ambulatory BP assessment may aid carotid risk stratification in poorly controlled T2D; leaves open causality of glycemic interaction pending prospective study.
Background: Ambulatory blood pressure monitoring (ABPM) is widely used in diabetes for cardiovascular risk assessment, but its link to early atherosclerosis, such as carotid plaques, is less clear. Aim: To assess associations between ABPM parameters and carotid plaques in type 2 diabetes by HbA1c level. Methods: This was a cross-sectional observational analysis conducted among patients with type 2 diabetes mellitus from the MMC platform.We analyzed 498 patients with 24-hour ABPM and carotid ultrasound, stratified by HbA1c (< 5.7%, 5.7– 6.4%, > 6.4%). Logistic regression examined associations, with sensitivity and subgroup analyses.Model was adjusted for potential confounders including age, sex, BMI, history of hypertension, smoking, alcohol consumption, marital status, and educational attainment. Results: Carotid plaque prevalence was 46.6%. After covariate adjustment, elevated systolic BP (SBP) was significantly associated with plaques only in HbA1c ≥ 6.4%: 24-hour SBP ≥ 130 mmHg (OR=2.14, 95% CI: 1.30– 3.56), awake SBP ≥ 135 mmHg (OR=1.87, 95% CI: 1.14– 3.11), and asleep SBP ≥ 120 mmHg (OR=1.78, 95% CI: 1.08– 2.95). No significant associations were observed for diastolic BP or in lower HbA1c groups. Findings were consistent across sensitivity and subgroup analyses. Conclusion: In poorly controlled diabetes, elevated SBP by ABPM is independently associated with carotid plaques, supporting combined ABPM and HbA1c assessment for early vascular risk detection.
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Liu et al. (2026) conducted a cross-sectional in Type 2 diabetes mellitus (n=498). Elevated ambulatory systolic blood pressure vs. Normal ambulatory systolic blood pressure was evaluated on Presence of carotid plaque (OR 2.14, 95% CI 1.30-3.56, p=0.005). Elevated 24-hour systolic blood pressure (≥130 mmHg) was independently associated with a higher risk of carotid plaques in patients with type 2 diabetes and HbA1c ≥6.4%.
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