Impact of Diabetes on Cardiac Function in Patients with High Blood Pressure

Nabila Soufi Taleb Bendiab, Souhila Ouabdesselam, Latefa Henaoui, Marilucy Lopez-Sublet, Jean-Jacques Monsuez and Salim Benkhedda
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Nabila Soufi Taleb Bendiab: Department of Cardiology, Faculty of Medicine Aboubekr Belkaid, University Hospital Tlemcen, Tlemcen 13000, Algeria
Souhila Ouabdesselam: Department of Cardiology, Mustapha University Hospital Center Algiers, Algiers 16000, Algeria
Latefa Henaoui: Department of Epidemiology, Faculty of Medicine Aboubekr Belkaid, University Hospital Tlemcen, Tlemcen 13000, Algeria
Marilucy Lopez-Sublet: APHP Hôpital R Muret, Hôpitaux Universitaires de Paris Seine Saint Denis, 93270 Sevran, France
Jean-Jacques Monsuez: APHP Hôpital R Muret, Hôpitaux Universitaires de Paris Seine Saint Denis, 93270 Sevran, France
Salim Benkhedda: Department of Cardiology, Mustapha University Hospital Center Algiers, Algiers 16000, Algeria

IJERPH, 2021, vol. 18, issue 12, 1-8

Abstract: Background : Although the combination of high blood pressure (HBP) and type 2 diabetes (T2DM) increases the risk of left ventricular (LV) dysfunction, the impact of T2DM on LV geometry and subclinical dysfunction in hypertensive patients and normal ejection fraction (EF) has been infrequently evaluated. Methods : Hypertensive patients with or without T2DM underwent cardiac echocardiography coupled with LV global longitudinal strain (GLS) assessment. Results : Among 200 patients with HBP (mean age 61.7 ± 9.7 years) and EF > 55%, 93 had associated T2DM. Patients with T2DM had a higher body mass index (29.9 ± 5.1 kg/m 2 vs. 29.3 ± 4.7 kg/m 2 , p = 0.025), higher BP levels (158 ± 23/95 ± 13 vs. 142 ± 33/87 ± 12 mmHg, p = 0.003), a higher LV mass index (115.8 ± 32.4 vs. 112.0 ± 24.7 g/m 2 , p = 0.004), and higher relative wall thickness (0.51 ± 0.16 vs. 0.46 ± 0.12, p = 0.0001). They had more frequently concentric remodeling (20.4% vs. 16.8%, p < 0.001), concentric hypertrophy (53.7% vs. 48.6%, p < 0.001), elevated filling pressures (25.8 vs. 12.1%, p = 0.0001), indexed left atrial volumes greater than 28 mL/m 2 (17.2 vs. 11.2%, p = 0.001), and a reduced GLS less than ?18% (74.2 vs. 47.7%, p < 0.0001). After adjustment for BP and BMI, T2DM remains an independent determinant factor for GLS decline (OR = 2.26, 95% CI 1.11–4.61, p = 0.023). Conclusions: Left ventricular geometry and subclinical LV function as assessed with GLS are more impaired in hypertensive patients with than without T2DM. Preventive approaches to control BMI and risk of T2DM in hypertensive patients should be emphasized.

Keywords: diabetes; hypertension; left ventricular function; global longitudinal strain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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