Special features of the Ambulatory measure of the blood pressure (MAPA) in diabetic subjects

The association arterial high blood pressure ( HTA) and diabetes is frequent. It potentiates the risk of death and cardiovascular complications. Therefore, a good diagnosis of HTA and its control is very important. The purpose of our study is to show the contribution of the ambulatory measure of the blood pressure and the particularities of diabetic patients with high blood pressure. It is about a forward-looking study over a period of one year, having concerned 100 diabetic patients with high blood pressure, and 100 non diabetic patients with high blood pressure, followed up the cardiology service at the Military Hospital AVICENE of Marrakesh. The average age of our diabetic patients was 57,79 ± 7,9 years old, with a sex-ratio of 1,08 against 49,60 ± 10,8 years, and a sex-ratio of 1,43 for the non diabetic patients. The MAPA allowed to objectify an unbalanced HTA for 66 diabetic patients, against 80 unbalanced patients by the clinical measure, and 16 patients balanced by MAPA against 20 patients considered well-balanced by clinical measure, with a rate of concordance between MAPA and clinical measure of 80 %, coefficient kappa of 0,77. While in the group of obvious non diabetics, the MAPA showed that 72 patients were unbalanced against 74 according to the clinical measure, and 28 patients balanced according to the MAPA against 26 according to the clinical measure, with a rate of 72 % concordance and a coefficient kappa of 0,55. The significant contribution of MAPA allowed him to occupy a prominent place in the treatment of hypertension in diabetic or not. Despite the cost of this technique, its use should be common practice.