The relationship between central hemodynamics, morning blood pressure surge, glycemic control and sodium intake in patients with type 2 diabetes and essential hypertension

The current study aimed to investigate the relationship between morning blood pressure surge (MBPS), hemodynamic parameters, glycemic control and 24-h urinary sodium excretion (USE) in patients with type 2 diabetes mellitus (T2DM).MBPS and central hemodynamic parameters were assessed from ambulatory blood pressure measurements. In addition to routine biochemistry, 24h urine collection was performed to measure protein, albumin and sodium excretion.There were 146 (38%) patients with T2DM and 238 (72%) patients without T2DM (control group). Patients with T2DM had statistically higher MBPS compared with patients without T2DM (P0.0001). In patients with T2DM, MBPS was correlated with HbA1c (rho=0.311, P0.0001), 24h urinary sodium excretion (USE) (rho=0.292, P=0.004) and various hemodynamic parameters. Additionally, regression analysis showed that being male (P=0.006), the presence of coronary artery disease (P=0.023), HbA1c (P=0.012), and 24h USE (P=0.001) were independently related with log MBPS in T2DM patients.This study demonstrated that T2DM was an independent risk factor for increased MBPS and MBPS was associated with central hemodynamic parameters. Additionally poor glycemic control and sodium intake were associated with worse MBPS in T2DM.