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PREVELANCE OF MASKED HYPERTENSION İN TYPE 2 DIABETIC PATIENTS AND CORRELATION WITH HBA1C LEVELS

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Introduction Hypertension is a significant health problem due to its very high prevalence and associated risks of cardiovascular, cerebrovascular and renal complications (1) In a significant number of patients control of hypertension is difficult,in spite of effective therapy strategies (2,3). Pickering et al.(4) first determined the phenomenon of masked hypertension (MH) to describe the clinical condition of patients with elevated ambulatory blood pressure (ABP) but normal clinical blood pressure(CBP). Most of these patients were not aware of their blood pressure status and so were not receiving antihypertensive therapy (4). These MHT patients presented with target organ damages, as albuminuria and left ventricular hypertrophy. Indeed, cardiovascular disease risk is even higher in MH patients than in essential hypertensive patients.(4). MHT is a public health concern with the confluence of increased CVD risk, a failure to be diagnosed by the conventional approach of blood pressure measurement in the clinic setting, and relatively high prevalence (5,6,7,8). According to the landmark SHEAF study patients with MH are at increased risk of developing sustained hypertension (9,10). Masked hypertension (MHT) is clinically defined in non-diabetics as an office blood pressure (BP) levels lower than 140/90 mmHg and daytime BP > 135/85 using ambulatory BP monitoring (ABPM),and in those with diabetes as a OBP <130/80 mmHg and a ABPM >125/75 mmHg (11). The prevalence of MHT is accepted as 8-10% among the general population. Among the diabetic population masked hypertension prevalance is increased about two to six times in comparison to general population. In the current literature, MHT is associated with increased macrovascular and microvasc... ... middle of paper ... ...5 need intensive blood pressure regulation to prevent target organ damages. Study limitations The number of diabetic patients in this study is limited,because as a tertiary center diabetic patients referred to our institution were complex patients and most of them had overt hypertension. The second limitation of our study is;we could not make an analysis for determining factors of masked hypertension other than poor glycemic control,due to limited number of patients. Conclusion Masked hypertension incidence is increased diabetic patients especially with high HbA1c levels,even though it is not statistically different and patients of which HbA1c levels>6.5 had higher blood pressure measurements in ABPM. T2DM patients with a potentially high risk of clinical cardiovascular diseases and hypertension-induced damage to target organs should be finically evaluated for MH.
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