# Patterns of Ambulatory Blood Pressure in Normotensive Patients With Type 2 Diabetes Mellitus Attending a Tertiary Care Hospital in South India

## TL;DR

This study shows that many type 2 diabetes patients with normal office blood pressure have hidden hypertension, highlighting the need for ambulatory monitoring.

## Contribution

The study identifies masked hypertension patterns in normotensive type 2 diabetes patients using ambulatory blood pressure monitoring in a South Indian hospital.

## Key findings

- 38.6% of normotensive type 2 diabetes patients had masked hypertension.
- Among masked hypertensives, 63.63% had both daytime and nocturnal hypertension.
- Age was a significant factor influencing masked hypertension.

## Abstract

Systemic hypertension (HTN) is one of the most common comorbidities in diabetes mellitus (DM). Diabetic patients with HTN have a several-fold increased risk of cardiovascular disease (CVD) as compared to normotensive nondiabetic controls. Routine office blood pressure (BP) measurement does not help diagnose hypertensive phenotypes such as masked hypertension, white coat hypertension, etc. Hence, ambulatory blood pressure monitoring (ABPM) is a valuable tool for diagnosing these conditions, as it can help identify adverse cardiovascular complications.

Aims: To study the patterns of ambulatory blood pressure profile in normotensive patients with type 2 DM.

Methodology: This was a cross-sectional study conducted among all patients aged 18 years and above who attended the endocrinology outpatient department of a tertiary care hospital.

Results: The total number of participants in the study was 57, with a mean age of 55.26 years (SD 13.52) among patients. Males comprised the majority, at 32 (56.1%). Masked hypertension was found in 22 (38.6%) patients who had normal blood pressure on routine office BP measurements. Among the masked hypertensive group, 10 (45.5%) patients were dippers, nine (40.9%) were non-dippers, and the rest were reverse dippers. Of those with masked hypertension, 4.54% (n=1) had isolated daytime hypertension, 31.8% (n=7) had isolated nocturnal hypertension, and 63.63% (n=14) had both. Age was the factor that influenced masked hypertension in the study.

Conclusions: The present study underscores the need to incorporate routine utilization of ambulatory blood pressure monitoring in patients with type 2 DM for early identification of hypertension. Solely depending upon office blood pressure monitoring might not be sufficient to detect the hypertensive phenotypes in patients with type 2 DM.