Glycated hemoglobin correlates with arterial stiffness and endothelial dysfunction in patients with resistant hypertension and uncontrolled diabetes mellitus

This study aimed to evaluate the effects of glycated hemoglobin (HbA1c) on flow‐mediated dilation, intima‐media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN–controlled diabetes mellitus and RHTN–uncontrolled type 2 diab...

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Published inThe journal of clinical hypertension (Greenwich, Conn.) Vol. 20; no. 5; pp. 910 - 917
Main Authors Moreno, Beatriz, Faria, Ana Paula, Ritter, Alessandra Mileni Versuti, Yugar, Lara Buonalumi Tacito, Ferreira‐Melo, Silvia Elaine, Amorim, Rivadavio, Modolo, Rodrigo, Fattori, André, Yugar‐Toledo, Juan Carlos, Coca, Antonio, Moreno, Heitor
Format Journal Article
LanguageEnglish
Published United States John Wiley and Sons Inc 01.05.2018
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Online AccessGet full text
ISSN1524-6175
1751-7176
1751-7176
DOI10.1111/jch.13293

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Abstract This study aimed to evaluate the effects of glycated hemoglobin (HbA1c) on flow‐mediated dilation, intima‐media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN–controlled diabetes mellitus and RHTN–uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA1c <7.0% (RHTN–controlled diabetes mellitus: n = 98) and HbA1c ≥7.0% (RHTN–uncontrolled diabetes mellitus: n = 122). Intima‐media thickness and flow‐mediated dilation were measured by high‐resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid‐femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN–uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN–uncontrolled diabetes mellitus. Intima‐media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA1c was an independent predictor of flow‐mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA1c may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.
AbstractList This study aimed to evaluate the effects of glycated hemoglobin (HbA1c) on flow‐mediated dilation, intima‐media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN–controlled diabetes mellitus and RHTN–uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA1c <7.0% (RHTN–controlled diabetes mellitus: n = 98) and HbA1c ≥7.0% (RHTN–uncontrolled diabetes mellitus: n = 122). Intima‐media thickness and flow‐mediated dilation were measured by high‐resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid‐femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN–uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN–uncontrolled diabetes mellitus. Intima‐media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA1c was an independent predictor of flow‐mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA1c may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.
This study aimed to evaluate the effects of glycated hemoglobin (HbA 1c ) on flow‐mediated dilation, intima‐media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN–controlled diabetes mellitus and RHTN–uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA 1c <7.0% ( RHTN–controlled diabetes mellitus : n = 98) and HbA 1c ≥7.0% ( RHTN –uncontrolled diabetes mellitus: n = 122). Intima‐media thickness and flow‐mediated dilation were measured by high‐resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid‐femoral pulse wave velocity . No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN –uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN –uncontrolled diabetes mellitus. Intima‐media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA 1c was an independent predictor of flow‐mediated dilation and pulse wave velocity in all patients with RHTN . In conclusion, HbA 1c may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.
This study aimed to evaluate the effects of glycated hemoglobin (HbA ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN-controlled diabetes mellitus and RHTN-uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA <7.0% (RHTN-controlled diabetes mellitus: n = 98) and HbA ≥7.0% (RHTN-uncontrolled diabetes mellitus: n = 122). Intima-media thickness and flow-mediated dilation were measured by high-resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid-femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN-uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN-uncontrolled diabetes mellitus. Intima-media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA was an independent predictor of flow-mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.
This study aimed to evaluate the effects of glycated hemoglobin (HbA1c ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN-controlled diabetes mellitus and RHTN-uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA1c <7.0% (RHTN-controlled diabetes mellitus: n = 98) and HbA1c ≥7.0% (RHTN-uncontrolled diabetes mellitus: n = 122). Intima-media thickness and flow-mediated dilation were measured by high-resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid-femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN-uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN-uncontrolled diabetes mellitus. Intima-media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA1c was an independent predictor of flow-mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA1c may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.This study aimed to evaluate the effects of glycated hemoglobin (HbA1c ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN-controlled diabetes mellitus and RHTN-uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA1c <7.0% (RHTN-controlled diabetes mellitus: n = 98) and HbA1c ≥7.0% (RHTN-uncontrolled diabetes mellitus: n = 122). Intima-media thickness and flow-mediated dilation were measured by high-resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid-femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN-uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN-uncontrolled diabetes mellitus. Intima-media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA1c was an independent predictor of flow-mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA1c may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.
Author Ritter, Alessandra Mileni Versuti
Coca, Antonio
Moreno, Beatriz
Fattori, André
Faria, Ana Paula
Ferreira‐Melo, Silvia Elaine
Modolo, Rodrigo
Yugar‐Toledo, Juan Carlos
Moreno, Heitor
Amorim, Rivadavio
Yugar, Lara Buonalumi Tacito
AuthorAffiliation 1 Laboratory of Cardiovascular Pharmacology School of Medical Sciences University of Campinas Campinas SP Brazil
5 Hypertension and Vascular Risk Unit Department of Internal Medicine Hospital Clínic (IDIBAPS) Effect University of Barcelona Barcelona Spain
3 University of Brasilia (UnB) Brasilia DF Brazil
2 Faculty of Medicine São José do Rio Preto – FAMERP São José do Rio Preto SP Brazil
4 Faculty of Medical Sciences Department of Internal Medicine‐Cardiology Division University of Campinas Campinas SP Brazil
AuthorAffiliation_xml – name: 1 Laboratory of Cardiovascular Pharmacology School of Medical Sciences University of Campinas Campinas SP Brazil
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– name: 4 Faculty of Medical Sciences Department of Internal Medicine‐Cardiology Division University of Campinas Campinas SP Brazil
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  fullname: Moreno, Heitor
  organization: University of Campinas
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29729072$$D View this record in MEDLINE/PubMed
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Issue 5
Keywords diabetes mellitus
flow-mediated dilation
pulse wave velocity
cardiovascular remodeling
resistant hypertension
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Snippet This study aimed to evaluate the effects of glycated hemoglobin (HbA1c) on flow‐mediated dilation, intima‐media thickness, pulse wave velocity, and left...
This study aimed to evaluate the effects of glycated hemoglobin (HbA 1c ) on flow‐mediated dilation, intima‐media thickness, pulse wave velocity, and left...
This study aimed to evaluate the effects of glycated hemoglobin (HbA ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left...
This study aimed to evaluate the effects of glycated hemoglobin (HbA1c ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left...
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SubjectTerms Aged
Arterial Stiffness
Body Mass Index
cardiovascular remodeling
Carotid Intima-Media Thickness - statistics & numerical data
diabetes mellitus
Diabetes Mellitus, Type 2 - metabolism
Diabetes Mellitus, Type 2 - physiopathology
Echocardiography - methods
Endothelium, Vascular - metabolism
Endothelium, Vascular - physiopathology
Female
flow‐mediated dilation
Glycated Hemoglobin A - metabolism
Heart Ventricles - anatomy & histology
Humans
Hypertension - metabolism
Hypertension - physiopathology
Male
Middle Aged
Original Paper
Pulse Wave Analysis - methods
pulse wave velocity
resistant hypertension
Ultrasonography - methods
Vascular Stiffness - drug effects
Title Glycated hemoglobin correlates with arterial stiffness and endothelial dysfunction in patients with resistant hypertension and uncontrolled diabetes mellitus
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fjch.13293
https://www.ncbi.nlm.nih.gov/pubmed/29729072
https://www.proquest.com/docview/2035241963
https://pubmed.ncbi.nlm.nih.gov/PMC8030801
Volume 20
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