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 in | The journal of clinical hypertension (Greenwich, Conn.) Vol. 20; no. 5; pp. 910 - 917 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
John Wiley and Sons Inc
01.05.2018
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Online Access | Get full text |
ISSN | 1524-6175 1751-7176 1751-7176 |
DOI | 10.1111/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. |
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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 – name: 3 University of Brasilia (UnB) Brasilia DF Brazil – name: 5 Hypertension and Vascular Risk Unit Department of Internal Medicine Hospital Clínic (IDIBAPS) Effect University of Barcelona Barcelona Spain – name: 4 Faculty of Medical Sciences Department of Internal Medicine‐Cardiology Division University of Campinas Campinas SP Brazil – name: 2 Faculty of Medicine São José do Rio Preto – FAMERP São José do Rio Preto SP Brazil |
Author_xml | – sequence: 1 givenname: Beatriz surname: Moreno fullname: Moreno, Beatriz organization: University of Campinas – sequence: 2 givenname: Ana Paula orcidid: 0000-0001-8585-7238 surname: Faria fullname: Faria, Ana Paula organization: University of Campinas – sequence: 3 givenname: Alessandra Mileni Versuti orcidid: 0000-0002-4434-4791 surname: Ritter fullname: Ritter, Alessandra Mileni Versuti organization: University of Campinas – sequence: 4 givenname: Lara Buonalumi Tacito surname: Yugar fullname: Yugar, Lara Buonalumi Tacito organization: Faculty of Medicine São José do Rio Preto – FAMERP – sequence: 5 givenname: Silvia Elaine surname: Ferreira‐Melo fullname: Ferreira‐Melo, Silvia Elaine organization: University of Campinas – sequence: 6 givenname: Rivadavio surname: Amorim fullname: Amorim, Rivadavio organization: University of Brasilia (UnB) – sequence: 7 givenname: Rodrigo surname: Modolo fullname: Modolo, Rodrigo organization: University of Campinas – sequence: 8 givenname: André surname: Fattori fullname: Fattori, André organization: University of Campinas – sequence: 9 givenname: Juan Carlos orcidid: 0000-0001-6583-6536 surname: Yugar‐Toledo fullname: Yugar‐Toledo, Juan Carlos email: yugarjuan@uol.com.br organization: Faculty of Medicine São José do Rio Preto – FAMERP – sequence: 10 givenname: Antonio surname: Coca fullname: Coca, Antonio organization: University of Barcelona – sequence: 11 givenname: Heitor surname: Moreno fullname: Moreno, Heitor organization: University of Campinas |
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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 |
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