Objective      To explore the characteristics of morning blood pressure surge in the hypertensive patients combined with or without type 2 diabetes mellitus (T2DM) and its correlation with the severity of coronary artery lesions. Methods      A total of 244 hypertensive inpatients (118 males and 126 females

at a mean age of 64.7±11.5) admitted in our department from January 2014 to August 2015 were recruited in this study. According to their morning blood pressure surge (MBPS) and complication with T2DM or not

the subjects were divided into 4 groups

that is

diabetes+MBPS group (D-S group

n=36)

diabetes+ non-MBPS group (D-nS group

n=56)

non-diabetic+ MBPS group (nD-S group

n=72)

and non-diabetic group+non-MBPS (nD-nS group

n=80). All 244 patients received coronary angiography

and the severity of coronary artery lesions were compared in the 4 groups. Results      The 24-hour mean systolic blood pressure (24 h MSB) and day systolic blood pressure (dSBP) were significantly higher in the D-S group

D-nS group and nD-S group than the nD-nS group (P0.05). The 24-hour mean diastolic blood pressure (24 h MDBP) and day diastolic blood pressure (dDBP) were higher in the D-S group than the D-nS group

nD-S group and nD-nS group (P0.05). The MBPS groups had higher rates of 3-essel disease and type C lesion

and higher total Gensini scores (P0.01). Pearson correlation analysis showed that the severity of coronary lesions was positively correlated to age (r=0.786

P0.01)

body mass index (BMI

r=0.284

P0.05)

fasting blood glucose (FBG

r=0.712

P0.05)

low-density lipoprotein-cholesterol (LDL-C

r=0.765

P0.05)

MBPS (r=0.852

P0.01) and 24-hour mean systolic blood pressure (24 h MSBP

r=0.804

P0.01). Multivariate linear regression analysis indicated that FBG

24 h MSBP and MBPS were the independent risk factors for coronary lesions. Conclusion      MBPS is an independent risk factor to predict the severity of coronary heart disease in essential hypertension patients with diabetes. Effective controlling of blood pressure and stably 24-hour long-term reducing blood pressure in this kind of patients can reduce target-organ damage and cardiovascular events in the patients