Is the higher incidence of ischemic disease in patients with hypertension and diabetes related to intracellular depletion of high energy metabolites?
To study mechanisms underlying ischemia in hypertension and non-insulin dependent diabetes mellitus (NIDDM), 31P-magnetic resonance spectroscopy was used to evaluate adenosine triphosphate and 2,3 diphosphoglycerate (2,3 DPG) levels in erythrocytes of control (n = 21), hypertensive (n = 22), and NIDDM (n = 10) subjects. Compared to adenosine triphosphate levels in controls (2.22 +/- 0.10 mM), both hypertensive (1.89 +/- 0.10 mM, sig = 0.05 versus normal) and NIDDM subjects (1.57 +/- 0.13 mM, sig = 0.05 versus normal) exhibited lower values. NIDDM subjects also displayed suppressed levels of 2,3 DPG (6.84 +/- 0.48 mM, sig = 0.05 versus normal and EH), compared to hypertensives (8.34 +/- 0.27 mM). These data suggest cellular energy metabolism is disrupted in hypertension and NIDDM. Both conditions may thereby sensitize tissues to ischemic damage, lower adenosine triphosphate levels by decreasing energy reserves, and lower 2,3 DPG levels by inhibiting hemoglobin-oxygen dissociation.
Resnick
L M
LM
Cardiovascular Center, Cornell University Medical Center, New York.
Gupta
R K
RK
Barbagallo
M
M
Laragh
J H
JH
D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004163:Diphosphoglyceric Acids / Q000032:analysis*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007511:Ischemia / Q000209:etiology*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged
D004163:Diphosphoglyceric Acids; D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate