Impact of diabetes on left ventricular diastolic function in patients with arterial hypertension.
OBJECTIVE
To analyse the effect of diabetes (DM) on diastolic function in hypertensive patients.


METHODS
439 hypertensive patients were selected for participation in this study. All participants had an echocardiographic evaluation of systolic and diastolic function. The overall degree of diastolic function and specific parameters (e.g. E/Ea ratio) were analysed.


RESULTS
We divided the cohort (63+/-10 years) into those with diabetes mellitus (DM(+), n=124) and without diabetes mellitus (DM(-), n=315). The prevalence of normal diastolic function was lower in DM(+) than DM(-) (19.4% vs. 30.8%); mild (65.3% vs. 60.0%) and moderate/ severe diastolic dysfunction were more frequent in DM(+) (15.3% vs. 9.2%, p=0.022). The E/Ea ratio, an estimate of left ventricular end-diastolic pressure, was significantly higher in DM(+) (12.3+/-4.4) as compared to DM(-) (10.8+/-3.6, p<0.001). Sex-specific analysis revealed that the effect of DM on diastolic function was mainly limited to the male subgroup. Multivariate logistic regression analysis showed that diabetes affected diastolic function in males independent of blood pressure, left ventricular mass index, concomitant medication and prevalence of coronary artery disease.


CONCLUSIONS
Diabetes negatively affects diastolic function in patients with arterial hypertension. This effect is mainly confined to the male subgroup.
Wachter
Rolf
R
Department of Cardiology and Pneumology, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
Lüers
Claus
C
Kleta
Sibylle
S
Griebel
Kerstin
K
Herrmann-Lingen
Christoph
C
Binder
Lutz
L
Janicke
Nico
N
Wetzel
Dirk
D
Kochen
Michael M
MM
Pieske
Burkert
B
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000187:drug effects
D007004:Hypoglycemic Agents