Central Blood Pressure Association with Micro- and Macro-vascular Complications in A sample of type 2 Diabetic Patients: A Case-Control Study

Background Vascular complications in diabetes and hypertension significantly contribute to cardiovascular morbidity and mortality. Aim This study assessed the association between central blood pressure and vascular complications in patients with type 2 diabetes and hypertension. It also explored its role in predicting microvascular and macrovascular complications. Methods This case-control study included 100 patients aged 40 to 60 years with type 2 diabetes and newly diagnosed hypertension: 50 cases with vascular complications and 50 controls. Patients were further stratified based on the presence of microvascular or macrovascular complications. Central and peripheral blood pressures, carotid intima-media thickness, ankle-brachial index, and augmentation index standardized to 75 beats per minute were measured. Other variables assessed included demographic data, anthropometric measurement, systemic examination, laboratory data, echocardiographic parameters, fundus findings, and glucose parameters. Results Central systolic and diastolic blood pressures were significantly higher in cases than controls (p < 0.05). Subgroup analyses showed that central systolic blood pressure was significantly higher in patients with both microvascular and macrovascular complications (p < 0.05). Logistic regression analyses performed for each subgroup demonstrated that central systolic blood pressure independently predicted microvascular (odds ratio = 1.064, 95 percent confidence interval: 1.030 to 1.099) and macrovascular (odds ratio = 1.183, 95 percent confidence interval: 1.097 to 1.275) complications. Predictive abilities were comparable to those of peripheral systolic blood pressure. Conclusion Central systolic blood pressure is significantly associated with vascular complications and independently predicts both microvascular and macrovascular complications. It demonstrated similar predictive ability for microvascular complications and a marginally stronger predictive ability for macrovascular complications.