67-PUB: Ambulatory Blood Pressure Monitoring among Type 2 Diabetes Mellitus Patients in India—A Prospective Observational Study

T2DM increases the risk of HTN, with 35-75% of diabetes-related complications linked to HTN. Traditional HTN measurement methods, including single-office BP measurements, may be fallacious and miss out on masked HTN and desynchrony in nocturnal BP. This multicentric, cross-sectional study aimed to assess different BP parameters in Indian patients with T2DM. A total of 229 T2DM patients (mean age [range]: 56.8 [17-88] years and 139 were men) with normal clinical BP (<140/90 mmHg) who visited the investigating doctors for routine clinical management of T2DM over 6 months were included and further referred for ABPM. The 24-hour (h) ABPM device was connected to the patient at the clinic during a routine visit and was collected the following day. The ABPM report was sent to the treating doctor, and the collected data was analyzed using an Excel spreadsheet. HTN defined by either elevated 24-h mean or daytime or nighttime BP was detected in 138 (60.27%) patients who were normotensives during the office visit. The majority of these were either female patients (n=45), and/or who were aged >60 years. Among 229 patients, the observed nocturnal BP patterns exhibited as follows: normal dippers (10-20%) were seen in 66 patients (28.8%), excess dippers (>20%) in 4 patients (1.74%), non-dippers (<10%) in 112 patients (48.9%), static BP (no BP fluctuations) in 4 patients (1.74%), and BP risers at night in 43 patients (18.77%). Only 66 patients (28.8%) had normal dipping circadian BP patterns. HCPs often label patients as normotensive based on a single clinic-based reading, but this can be misleading. A significant number of T2DM patients labeled normotensives may be hypertensives or have nocturnal BP desynchrony, negatively impacting their prognosis. Physicians should therefore check the BP of their T2DM patients in each visit and on suspicion of HTN mediated organ damage; subject the patient to 24-h ABPM study to detect such cases which are missed out by taking office BP.