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Effect of essential hypertension on cardiac autonomic function in type 2 diabetic patients.

Abstract：

OBJECTIVES:The aim of this study was to examine the effects of essential hypertension on cardiac autonomic function in type 2 diabetic patients. BACKGROUND:Hypertension is common in type 2 diabetic patients and is associated with a high mortality. However, the combined effects of type 2 diabetes and essential hypertension on cardiac autonomic function have not been fully elucidated. METHODS:Thirty-three patients with type 2 diabetes were assigned to a hypertensive diabetic group (n = 15; age: 56 +/- 8 years, mean +/- SD) or an age-matched normotensive diabetic group (n = 18, 56 +/- 6 years). Cardiac autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability (HRV), plasma norepinephrine concentration and cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphic findings. RESULTS:Baroreflex sensitivity was lower in the hypertensive diabetic group than it was in the normotensive diabetic group (p < 0.05). The early and delayed myocardial uptake of 123I-MIBG was lower (p < 0.01 and p < 0.05, respectively), and the percent washout rate of 123I-MIBG was higher (p < 0.05) in the hypertensive diabetic group. However, the high frequency (HF) power and the ratio of low frequency (LF) power to HF power (LF/HF) of HRV and plasma norepinephrine concentration were not significantly different. The homeostasis model assessment index was higher in the hypertensive diabetic group than it was in the normotensive diabetic group (p < 0.01). CONCLUSIONS:Our results indicate that essential hypertension acts synergistically with type 2 diabetes to depress cardiac reflex vagal and sympathetic function, and the results also suggest that insulin resistance may play a pathogenic role in these processes.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Takahashi N,Nakagawa M,Saikawa T,Ooie T,Yufu K,Shigematsu S,Hara M,Sakino H,Katsuragi I,Okeda T,Yoshimatsu H,Sakata T

doi

10.1016/s0735-1097(01)01363-8

subject

Has Abstract

pub_date

2001-07-01 00:00:00

pages

232-7

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(01)01363-8

journal_volume

pub_type

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Effect of essential hypertension on cardiac autonomic function in type 2 diabetic patients.