Blood pressure variability is associated with the occurrence of diabetic microangiopathy in type 2 diabetes mellitus: a cross-sectional study

OBJECTIVES: This study analyzed the relationship between blood pressure variability (BPV) and diabetic microangiopathy (DMAP). METHODS: A total of 240 type 2 diabetes mellitus (T2DM) patients were selectively enrolled, including 161 patients with DMAP and 79 patients without DMAP. Clinical baseline data were collected, and 24-h systolic BPV (24hSBPV), 24-h diastolic BPV (24hDBPV), daytime systolic BPV (dSBPV), daytime diastolic BPV (dDBPV), nighttime systolic BPV (nSBPV) and nighttime diastolic BPV (nDBPV) were measured by ambulatory blood pressure monitoring. Diagnostic value of triglyceride (TG), urine albumin-to-creatinine ratio (UACR), DM duration, 24hSBPV, dSBPV and nDBPV for DMAP was analyzed by receiver operating characteristic curves. RESULTS: There were significant differences in DM duration, systolic blood pressure, high-density lipoprotein cholesterol, UACR, TG, glycosylated hemoglobin, 24hSBPV, 24hDBPV, dSBPV, dDBPV, nSBPV, nDBPV between DMAP and non-DMAP patients. All these BPV parameters were highest in diabetic nephropathy (DN) patients, while only 24hSBPV showed a significant difference between diabetic retinopathy and diabetic peripheral neuropathy patients. 24hSBPV (area under the curve [AUC] = 0.915, P < 0.001, cutoff = 8.28), dSBPV (AUC = 0.847, P < 0.001, cutoff = 8.54), nDBPV (AUC = 0.785, P < 0.001, cutoff = 11.13) and combined detection of 24hSBPV, dSBPV and nDBPV (AUC = 0.941, P < 0.001, cutoff = 0.611) had certain diagnostic value for DMAP. CONCLUSIONS: BPV is elevated in DMAP patients, with the highest BPV observed in DN patients. 24hSBPV, dSBPV, and nDBPV are associated with DMAP occurrence in T2DM patients, and may assist in diagnosing DMAP.