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 diff erences in the eff ect of various antihypertensive agents on PSBP & CSBP was 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.