BLOOD PRESSURE PROFILE OF TYPE 2 DIABETIC PATIENTS WITH CARDIAC AUTONOMIC NEUROPATHY IN A YAOUNDÉ REFERRAL HOSPITAL

Objective: To describe the blood pressure profiles of type 2 diabetics with Cardiac Autonomic Neuropathy (CAN) Design and method: We conducted a descriptive cross-sectional study at the Yaounde Central Hospital from November 2023 to August 2024. Type 2 diabetics with or without hypertension were recruited. CAN was diagnosed when the Ewing score was greater than or equal to 2 after CART (Cardiac Autonomic Reflex Test) using a polar H10 cardio frequency meter. Results: Forty-nine patients, mainly women (57.1%) with an average age of 58.7 ± 10.6, were recruited. Before ambulatory blood pressure measurement (ABPM), 67.4% were known to be hypertensive. After ABPM, this rate rose to 85.7%, presenting 32.4% with hidden hypertension. CAN was diagnosed in 23 patients, that is, 48% of the population. Factors associated with CAN were a resting heart rate greater than 80bpm (p=0.006), a decrease in RMSSD (Root Mean Square of Successive Differences of R-R intervals) (p=0.002), and PNN50 (Percentage of normal intervals differing by more than 50ms) (p=0.041). Patients with cardiac autonomic neuropathy (CAN) had higher blood pressure, no systolic or diastolic dipping, and a wider pulse pressure compared with subjects without CAN, but this was not significant. The LF/HF (low frequency/high frequency) ratio was inversely correlated with the increase in nocturnal systolic and diastolic blood pressure. Conclusions: CAN is common in subjects with type 2 diabetes. It is associated with the absence of blood pressure dipping. Changes in sinus variability parameters are correlated with increases in blood pressure.