The optimal cut-off of blood pressure related to left ventricular diastolic dysfunction and remodeling in Asian diabetic patients. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Jung, Ju Young; Park, Sung Keun; Ryoo, Jae-Hong; Oh, Chang-Mo; Kang, Jeong Gyu; Moon, Kanghee; Lee, Keum Ok; Choi, Joong-Myung
• Is Part Of: Journal of cardiology. Volume 71:Issue 1(2018)
• Page Start: 16
• Page End: 23
• Publication Date: 2018-01
• Subjects: Diabetes mellitus -- Prehypertension -- Hypertension -- Left ventricular diastolic dysfunction -- Left ventricular remodeling; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2017.06.008
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: We investigated subclinical left ventricle (LV) changes in diabetic patients. Impaired LV diastolic function is related to the prehypertension (>130/80 mmHg). LV remodeling is associated with hypertension. Our result suggested clinical benefits of intensive blood pressure control. Abstract: Background: Although a recent randomized trial found no difference between intensive and standard blood pressure (BP) control in patients with diabetes mellitus (DM), the debate over the optimal BP target continues. Thus, the present study investigated the effect of BP on the subclinical left ventricular (LV) function and structural changes in diabetic patients. Method: A total of 2649 patients with DM who received echocardiography were enrolled in this study. Study population was stratified by three groups according to BP and presence of hypertension (normal, <130/80 mmHg; prehypertension, ≥130/80 mmHg without hypertension; hypertension, ≥140/90 mmHg or history of hypertension). The odds ratios (ORs) of impaired LV diastolic function and LV remodeling were analyzed using multivariate logistic regression analysis. The adjusted mean values of echocardiographic parameters related to LV diastolic function and remodeling were also evaluated. Result: When normal group was set as reference, the adjusted ORs [95% confidential interval (CI)] for impaired LV diastolic function was 2.45 (95% CI 1.84–3.24) in prehypertension, 3.51 (95% CI 2.57–4.80) in hypertension group. Adjusted ORs for LV remodeling only showed significant result in hypertension group [1.82 (95% CI 1.23–2.69)]. The adjusted mean value of LV diastolic function and structure also demonstrated LV deterioration in prehypertension and hypertension groups. Conclusion: Our study showed the adverse influence of prehypertension and hypertension on subclinical LV deterioration. This finding suggested the potential clinical benefits of intensive BP control (<130/80 mmHg) in patients with DM.