Significance of Measuring Central Systolic Blood Pressure in Type 2 Diabetic Patients: An Observational Study

Background: Data clearly shows a higher incidence of COVID 19 and worse outcomes in patients with diabetes and hypertension (30,31). Patients with T2DM are at a higher risk of developing cardiovascular disease, which is inadequately explained by conventional risk factors. CSBP is known to correlate with more cardiovascular events than standard mercury-based PSBP. Diabetic patients are known to have higher CSBP than non-diabetic individuals. There is a paucity of data about CSBP in diabetic patients in India, hence there is a perceived need for more studies in this area.

Design: Analytic (Cross-sectional) observational study.

Methods: The study was approved by the ‘Institutional Ethics Committee, Care Hospital’, Hyderabad, India. We assessed similar groups of T2DM patients and healthy individuals for CSBP measurement by “Pulsecor - BP+” device and compared them with standard mercury-based brachial PSBP measurement. In hypertensive diabetic patients, the differences in the eff ect of various antihypertensive agents on PSBP & CSBP were also studied.

Results: We found that a higher number of participants (T2DM 73% versus 61%, healthy individuals 22% versus 16.6%) had uncontrolled CSBP than the number of patients with high PSBP p < 0.01). In addition, it was observed that CSBP was better controlled in patients on RAS blockade drugs than in those receiving beta-blockers (33% versus 23%).

Conclusion: This study highlights the importance of measuring CSBP in T2DM patients to identify and treat those who would otherwise be missed by measuring only PSBP.

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