Clinical Research of Ambulatory Blood Pressure Monitoring in Elderly Patients with Primary Hypertension Combined with Type 2 Diabetes

Objective To observe the blood pressure level and the change of rhythm in senile patients with essential hypertension combined with type 2 diabetes.and explore their correlation with target organ damage.Methods A total of 117 cases of essential hypertension combined with type2 diabetes were recruited for the study,all patients received 24 h ambulatory blood pressure monitoring as well as fasting serum glucose,glycosylated hemoglobin,blood lipid,serum uric acid and renal function and urinary micro protein 5 items.The patients were divided into the dipper group(24 cases) and non-dipper group(93 cases).Results The incidence of target organ damage in non-dipper group was significantly higher than dipper group,and the difference was statistically significant(P 0.01).In addition,Non-dipper group showed significantly higher average night systolic blood pressure and night systolic blood pressure load than dipper group(P 0.01);Night systolic blood pressure reduction rates and night diastolic blood pressure reduction rates of Non-dippe group was significantly lower than dipper group(P 0.001);no significant difference was found between the two groups about fasting serum glucose glycosylated hemoglobin,blood lipid,blood uric acid,serum creatinine and urea nitrogen,and glomerular filtration.The urine micro protein 5 was significantly higher in non-dipper group than in dipper group(α1-MG,P1 0.01;β2-MG,P2 0.01;MA,P30.001;TRF,P4 0.001;IgG,P5 0.001).Conclusion Advanced age patients and non-dipper type hypertension were more common in elderly patients with essential hypertension combined with type 2 diabetes.Compared with dipper hypertension,non-dipper often combined with multiple target organ damage.For elderly patients with primary hypertension combined with type 2 diabetes mellitus,ambulatory blood pressure monitoring combined with urinary protein five has important clinical significance in prediction of early target organ damage.