Related Experiment Videos
The diabetic heart: clinical, experimental and pathological features
1Albert Einstein College of Medicine, Bronx, New York.
Insights
Diabetic heart disease is worsened by hypertension. Controlling both diabetes mellitus and hypertension may mitigate severe cardiac complications in patients.
Area of Science:
- Cardiology
- Endocrinology
- Pathology
Background:
- Patients with diabetes mellitus face increased cardiovascular disease risk.
- Complications are more severe when diabetes coexists with hypertension.
- Hypertension is a critical factor in severe diabetic heart disease pathogenesis.
Purpose of the Study:
- To investigate the combined impact of diabetes mellitus and hypertension on cardiac health.
- To elucidate the roles of diabetes and hypertension in the development of heart disease.
Main Methods:
- Review of human and experimental animal model evidence.
- Analysis of histopathologic myocardial damage and myocellular dysfunction in hypertensive-diabetic cardiomyopathy.
Main Results:
- Hypertension contributes to myocardial damage, while diabetes causes myocellular dysfunction.
- The combined effect of diabetes and hypertension on the myocardium is devastating.
- Microvascular consequences of both conditions exacerbate heart disease.
Conclusions:
- Strict control of diabetes mellitus and hypertension is crucial.
- Preventing microvascular complications may ameliorate diabetic heart disease progression.
Abstract:
Patients with diabetes mellitus are particularly vulnerable to cardiovascular disease. Although both the macrovascular and microvascular complications are present in patients with diabetes alone, they are particularly severe in patients with both diabetes and hypertension. While there is no doubt that a primary diabetic cardiomyopathy occurs with functional consequences, considerable evidence--both in humans and in experimental animal models--points to hypertension as of critical importance in the pathogenesis of severe pathological and symptomatic diabetic heart disease. In hypertensive-diabetic cardiomyopathy, the histopathologic myocardial damage has been attributed to hypertension, while the myocellular dysfunction has been attributed to diabetes. Together, the consequences to the myocardium are devastating. Strict control of the hypertension and diabetes mellitus, along with prevention of the microvascular consequences of both conditions, may have an ameliorative effect on the subsequent development of diabetic heart disease.