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Factors influencing LVM in hypertensive type-1 diabetic patients
E Gerdts1, O L Myking, P Lund-Johansen
1Department of Heart Disease, Haukeland Hospital, Bergen, Norway.
Insights
Dietary sodium intake significantly impacts left ventricular hypertrophy (LVH) in hypertensive type-1 diabetic patients. Reducing sodium may help manage LVH development in this population.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
Background:
- Diabetes mellitus frequently co-occurs with hypertension and left ventricular hypertrophy (LVH).
- Abnormal sodium metabolism is a suspected factor in diabetic cardiovascular complications.
- Left ventricular mass (LVM) is a key indicator of cardiac health.
Purpose of the Study:
- To investigate factors influencing left ventricular mass (LVM) in hypertensive type-1 diabetic patients.
- To determine the relationship between dietary sodium intake and LVH in this cohort.
- To identify independent predictors of LVM.
Main Methods:
- Echocardiography was used to measure LVM in 30 hypertensive type-1 diabetic patients.
- 24-hour urine samples assessed albumin excretion and sodium intake (as sodium excretion).
- Multiple regression analysis identified predictors of LVM.
Main Results:
- Dietary sodium intake and plasma atrial natriuretic peptide were independent predictors of LVM.
- 33% of patients exhibited left ventricular hypertrophy (LVH).
- No significant association was found between LVM and blood pressure or albuminuria.
Conclusions:
- Dietary sodium intake is a crucial factor in the development of LVH in hypertensive type-1 diabetic patients.
- Findings suggest that managing sodium intake could be a therapeutic target for preventing LVH in this population.
- Further research is warranted to explore the mechanisms linking sodium and cardiac remodeling in diabetes.
Abstract:
Diabetes mellitus is associated with a high prevalence of hypertension and left ventricular hypertrophy (LVH), and a causative relationship with abnormal sodium metabolism in diabetic patients has been suggested. Factors influencing left ventricular mass (LVM) were assessed in 30 hypertensive type-1 diabetic patients, mean age 46 +/- 9 (range 24-67) years, with a mean duration of diabetes and hypertension of 19 +/- 10 and 6 +/- 5 years, respectively. In the total study population, casual blood pressure was 163/94 +/- 24/10 mmHg and 24 h blood pressure was 155/87 +/- 17/8 mmHg. Twenty-four-hour urine samples were obtained to measure daily albumin excretion (0.77 +/- 1.06 g) and dietary sodium intake was assessed as 24 h sodium excretion (173 +/- 77 mmol). Creatinine clearance averaged 1.41 +/- 0.53 ml/s. LVM determined by echocardiography was 221 +/- 74 g (range 104-408 g) and 33% of the patients had LVH. Multiple regression analysis identified dietary sodium intake and plasma atrial natriuretic peptide as independent predictors of LVM (R2 = 0.52, p < 0.001). No significant association was found between LVM and blood pressure or albuminuria. The results propose dietary sodium intake as an important factor in the development of LVH in hypertensive type-1 diabetic patients.