Elevated 24-hour systolic blood pressure (≥130 mmHg) was independently associated with a higher risk of carotid plaques (OR 2.14) in patients with type 2 diabetes and HbA1c ≥6.4%.
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%).
Effect estimate: OR 2.14 (95% CI 1.30-3.56)
p-value: p=0.005
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 ( 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. Keywords: ambulatory blood pressure, systolic blood pressure, HbA1c, carotid plaque, diabetes mellitus
Liu et al. (Wed,) 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 (OR 2.14) in patients with type 2 diabetes and HbA1c ≥6.4%.