[PP.05.06] IN DIABETIC PORTUGUESE HYPERTENSIVE PATIENTS LOWERING NIGHT SYSTOLIC BLOOD PRESSURE IS ASSOCIATED WITH LESS CARDIOVASCULAR EVENTS IN A PORTUGUESE SAMPLE OF TREATED HYPERTENSIVES PATIENTS FOLLOWED FOR 11,8 ± 5,1 YEARS

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Abstract

Objective:

It's still uncertain if there is a limit to the reduction of systolic blood pressure in diabetic hypertensive patients. However it is well known that night systolic blood pressure (SBP) values are the most predictive of events.

Design and method:

Casual and ABP were obtained in 1200 hypertensive patients of witch 219 where diabetics (115 females, 52.5%) BMI 29.8 ± 4.8 followed by 11,8 ± 5,1 years..Of most of all we have the antoprometrc measures, lab data and echocardiographic data.

Results:

There were 85 events (47 strokes, 25 coronary events and 13 other cardiovascular – CV- events). During 21,2 years of follow-up (11,8 ± 5,1 years) there were 41 deaths 13 of which were CV. When we compare diabetics with events versus without events those with events were older, had higher 24 h, nighttime pulse pressure (PP),higher ambulatory arterial stiffness index and lower 24 h and nighttime heart rate. In a Kaplan Meier survival curves free of events those who have higher ventricular cardiac mass had the worst prognosis (log rank 7.6 p < 0.01). When the sample was analyzed by tercis of creatinine the higher the tercil the worst the survival curves (log rank 6.2 p < 0.05). When we analyzed the survival curves of Kaplan Meier free of events in order the night SBP quintis, the higher the quintil the worst survival curve (log rank 10.8 p < 0.05.

Conclusions:

In our diabetic population it seems that there is no J curve for the limit of achievement of blood pressure level if we analyzed this achivement in the night period where there is less behaviour physical and psychological interference.

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