Hyperglycemia and nocturnal systolic blood pressure are associatedwith left ventricular hypertrophy and diastolic dysfunction in hypertensive diabetic patients

Hyperglycemia and nocturnal systolic blood pressure are associatedwith left ventricular hypertrophy and diastolic dysfunction in hypertensive diabetic patients

Autor Felicio, Joao S. Google Scholar
Pacheco, Juliana T. Google Scholar
Ferreira, Sandra R. Google Scholar
Plavnik, Frida Autor UNIFESP Google Scholar
Moisés, Valdir Ambrósio Autor UNIFESP Google Scholar
Kohlmann Junior, Osvaldo Autor UNIFESP Google Scholar
Ribeiro, Artur Beltrame Autor UNIFESP Google Scholar
Zanella, Maria Teresa Autor UNIFESP Google Scholar
Instituição Fed Univ Para
Univ Nacl Estadual São Paulo
Universidade Federal de São Paulo (UNIFESP)
Resumo Background: the aim of this study was to determine if hypertensive type 2 diabetic patients, when compared to patients with essential hypertension have an increased left ventricular mass index (LVMI) and a worse diastolic function, and if this fact would be related to 24-h pressoric levels changes.Methods: Ninety-one hypertensive patients with type 2 diabetes mellitus (DM) (group-1 [G1]), 59 essential hypertensive patients (group-2 [G2]) and 26 healthy controls (group-3 [G3]) were submitted to 24-h Ambulatory Blood Pressure Monitoring (ABPM) and echocardiography (ECHO) with Doppler. We calculated an average of fasting blood glucose (AFBG) values of G1 from the previous 4.2 years and a glycemic control index (GCI) (percentual of FBG above 200 mg/dl).Results: G1 and G2 did not differ on average of diurnal systolic and diastolic BP. However, G1 presented worse diastolic function and a higher average of nocturnal systolic BP (NSBP) and LVMI (NSBP = 132 +/- 18 vs 124 +/- 14 mmHg; P < 0.05 and LVMI = 103 +/- 27 vs 89 +/- 17 g/m(2); P < 0.05, respectively). in G1, LVMI correlated with NSBP (r = 0.37; P < 0.001) and GCI (r = 0.29; P < 0.05) while NSBP correlated with GCI (r = 0.27; P < 0.05) and AFBG (r = 0.30; P < 0.01). When G1 was divided in tertiles according to NSBP, the subgroup with NSBP >= 140 mmHg showed a higher risk of LVH. Diabetics with NSBP >= 140 mmHg and AFBG>165 mg/dl showed an additional risk of LVH (P < 0.05; odds ratio = 11). in multivariate regression, both GCI and NSBP were independent predictors of LVMI in G1.Conclusion: This study suggests that hyperglycemia and higher NSBP levels should be responsible for an increased prevalence of LVH in hypertensive patients with Type 2 DM.
Idioma Inglês
Data de publicação 2006-01-01
Publicado em Cardiovascular Diabetology. London: Biomed Central Ltd, v. 5, 7 p., 2006.
ISSN 1475-2840 (Sherpa/Romeo, fator de impacto)
Publicador Biomed Central Ltd
Extensão 7
Fonte http://dx.doi.org/10.1186/1475-2840-5-19
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000208322700019
Endereço permanente http://repositorio.unifesp.br/handle/11600/28614

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