Characterization of postprandial blood pressure and pulse pressure in essential hypertension and type 2 diabetes milltus

Recent studies showed that the postprandial glucose and lipid were closely related to the risk of cardiovascular diseases and type 2 diabetes (DM). Excessive food uptake will trigger the cardiovascular events. Besides postprandial lipid and glucose, pulse pressure (PP) was also found to be an independent predictor for cardiovascular events compared with blood pressure (BP). However, the changes of postprandial BP and PP were little known in essential hypertension ( EH ) and type 2 DM. To characterize the status of postprandial BP and PP in EH and type 2 DM. 328 patients were included into this study: EH (n=116), type 2 DM (n=100) and hypertensive DM (n=112). Ambulatory blood pressure monitor and invasive arterial BP were examined before and after prandial. Postprandial SBP and DBP from 30 min. to 120 min. were significantly higher in EH than preprandial BP at the same time points (p<0.01). By contrast, postprandial BP significantly decreased in type 2 DM and hypertensive DM compared with preprandial BP at the same time points (P<0.05, P<0.01). However, postprandial PP significantly increased in EH and hypertensive DM (P<0.01), but not in type 2 DM. The reason of higher postprandial PP was due to an increase of postprandial SBP in EH and a decrease of postprandial DBP in hypertensive DM. Postprandial high BP and PP returning to preprandial status were slower in EH compared with type 2 DM and hypertensive DM. The similar trends of postprandial BP and PP were confirmed by the measurement of invasive arterial BP in partial EH and type 2 DM. It concluded that postprandial status had different effects on postprandial BP and PP in type 2 DM and EH. Differences of postprandial BP and PP between EH and type 2 DM may be dependent on the different status of large artery stiffness, peripheral arterial resistance and autonomic neuropathy. Postprandial BP and PP may be valuable in prediction of cardiovascular events.