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Impact of diabetes on treatment-induced changes in left ventricular structure and function in hypertensive patients

E Gerdts1, P M Okin, P Omvik

  • 1Institute of Medicine, University of Bergen. gerdtsev@online.no

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|March 24, 2009
PubMed

Insights

Diabetes hinders left ventricular hypertrophy regression and systolic function improvement in hypertensive patients undergoing treatment. This suggests diabetes negatively impacts cardiac remodeling and function despite blood pressure control.

Area of Science:

  • Cardiology
  • Endocrinology
  • Hypertension Research

Background:

  • Diabetes mellitus is linked to left ventricular hypertrophy (LVH) and impaired systolic function in hypertensive individuals.
  • Limited data exists on diabetes' effect on LVH regression and functional recovery during antihypertensive therapy.

Purpose of the Study:

  • To investigate the impact of diabetes on left ventricular hypertrophy (LVH) regression and systolic function improvement in hypertensive patients receiving antihypertensive treatment.

Main Methods:

  • Annual echocardiography was conducted over 4.8 years in hypertensive patients with electrocardiographic LVH from the LIFE study.
  • Patients received losartan- or atenolol-based treatment; 730 were non-diabetic and 93 were diabetic.
  • Multivariate analyses assessed independent predictors of LVH regression and functional improvement.

Main Results:

  • Diabetic patients had higher baseline body mass index, pulse pressure, and albuminuria, with lower LV ejection fraction and midwall shortening.
  • Despite similar blood pressure reduction, diabetic patients showed a higher prevalence of persistent LVH (47% vs. 39%).
  • Diabetes independently predicted less LV mass reduction and reduced improvement in stress-corrected LV midwall shortening.

Conclusions:

  • In hypertensive patients with LVH, diabetes is associated with more persistent LVH.
  • Diabetes independently predicts poorer LVH regression and less improvement in systolic function during antihypertensive treatment.
Abstract

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