12 July 2010 - Patients being treated for Type 2 diabetes (T2D) who have high carotid intima-media thickness (IMT) have increased risk for masked hypertension, suggest study results published n the journal Diabetes Research and Clinical Practice. 

Masked hypertension, hypertension not detected by routine blood pressure (BP) measurements, is known to have an impact on the development of myocardial hypertrophy and left ventricle diastolic dysfunction, but less is known about links with carotid artery changes, say researchers. 

Jiri Charvat, MD (Charles University, Prague, Czech Republic) and colleagues recruited 64 patients, aged 62 years on average, with T2D with an office BP below 140/90 mmHg to take part in the study. All the patients were being treated with antihypertensive medication. The patients were monitored using 24-hour BP monitoring and were scanned using carotid sonography to measure carotid IMT. 

The team reports that 24 (37.5%) participants had masked hypertension, defined as a mean daily ambulatory BP of 135/85 mmHg or above. 

They found that carotid IMT was significantly greater in patients with masked hypertension than in those without the condition, at 0.74 versus 0.69 mm on average. The relationship persisted after accounting for variables including age, duration of diabetes, and smoking status. 

"The present study demonstrated that Type 2 diabetic subjects with masked hypertension detected by ambulatory blood pressure monitoring had higher carotid IMT than those with normal blood pressure during daily hours," conclude the researchers. They add that the findings of this study agree with others data that carotid IMT is a useful marker for detecting subclinical atherosclerosis and predicting future cardiovascular events.