Abstract 305: Glycated Hemoglobin Levels Predict Arterial Stiffness nad Endothelial Dysfunction in Resistant Hypertensive Diabetic Subjects
Introduction: Endothelial function, intima-media thickness (IMT) and vascular stiffness are variables closely associated in normotensive subjects as well as in hypertensive and diabetic (DM) patients; however this correlation has not been tested in resistant hypertensive (RHTN) individuals. It is known that DM is a very common finding in RHTN, but it is controversial whether this condition causes some incremental impairment in vascular dysfunction in these patients. Also, it is controversial if glycated haemoglobin plasma levels predict arterial abnormalities in RHTN individuals.
Methods: Two hundred and six RHTN patients were divided in two groups: RHTN+DM (HBglic=7.3%, age= 58.7y, BMI= 30.8, n= 134) and RHTN-nonDM (5.5%, age= 58.3y, BMI= 30.5, n=72). Blood pressure (ABPM and office) was similar between the 2 groups (RHTN+DM= 150/87/63 and RHTN-nonDM= 151/89/62 mmHg; p> 0.05). Arterial rigidity (PWV, m/s, Sphygmocor system), endothelial function (FMD,%) and carotid IMT (mm) were assessed and parametric tests (t Student, Pearson correlation and linear regression) used analyse the data. Results (mean±SD): RHTN-DM group had higher values of PWV (12.1±1.6 vs. 10.7±1.7 m/s; p< 0.001) and lower measurements of FMD (7.3±1.8 vs. 8.2±1.9%; p<0.001); however, IMT values were found similar in the 2 groups (1.02±0.2 vs. 1.01±0.2 mm; p= 0.77). Hbglyc levels correlated with PWV (R=0.31; p<0.001) and FMD (R=-0,52; p<0,0001) only in the RHTN-DM group (RHTN-nonDM: R=0.01, p= 0.93, and R=-0.03, p=0.79, respectively). Linear regression analysis showed statistical significance between HbGlyc and PWV and e FMD only in RHTN-DM patients (p<0.05).
Conclusion: DM worsened endothelial dysfunction and vascular stiffness, but not IMT, in RHTN subjects. Glycated haemoglobin is an important predictor of arterial rigidity and endothelial function in diabetic RHTN subjects.
- © 2013 by American Heart Association, Inc.