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Title of Journal: Am J Hypertens

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Abbravation: American Journal of Hypertension

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Narnia

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DOI

10.1007/bf00842399

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0895-7061

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Arterial compliance changes in diabetic normotensi

Authors: Manolis Athanasios J Iraklianou Stella Pittaras Andreas Zairis Michael Tsioufis Konstantinos Psaltiras George Psomali Demetra Foussas Stefanos Gavras Irene Gavras Haralambos
Publish Date: 2005/01/01
Volume: 18, Issue: 1, Pages: 18-22
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Abstract

Athanasios J Manolis Stella Iraklianou Andreas Pittaras Michael Zairis Konstantinos Tsioufis George Psaltiras Demetra Psomali Stefanos Foussas Irene Gavras Haralambos Gavras Arterial compliance changes in diabetic normotensive patients after angiotensinconverting enzyme inhibition therapy American Journal of Hypertension Volume 18 Issue 1 January 2005 Pages 18–22 https//doiorg/101016/jamjhyper200408014Diabetes mellitus DM is known to cause increased arterial wall stiffness and increased cardiovascular risk even in the absence of hypertension This study was designed to investigate whether use of an angiotensinconverting enzyme ACE inhibitor may improve arterial stiffness in normotensive diabetics using pulse wave velocity PWV as a surrogate markerAt baseline PWV was significantly higher in DM patients versus controls 1309 ± 259 v 95 ± 16 m/sec respectively P 001 After 6 months PWV decreased significantly to 1168 ± 308 m/sec P 003 for the whole DM group However the results were driven by the change in the younger type 1 DM from 1259 ± 159 to 1035 ± 221 m/sec P 001 whereas in the type 2 DM it was insignificant from 1337 ± 30 to 1242 ± 328 m/sec Blood pressure and other hemodynamic and biochemical parameters remained unchangedThe results demonstrate that ACE inhibition can improve arterial elasticity and hence risk of cardiovascular complications even in normotensive diabetics This short treatment was effective only in younger patients with type 1 diabetes suggesting that early initiation of therapy before the onset of advanced structural alterations is likely to be more cardioprotective Am J Hypertens 2005 1818–22 © 2005 American Journal of Hypertension LtdDiabetes mellitus DM is associated with a marked increase in risk of cardiovascular mortality1 which is apparent even in patients with impaired glucose metabolism without clinically overt diabetes2 Atherosclerosis and arterial complications in diabetic patients appear to be progressively increasing and have been reported as the major causes of death in more than 50 of the fatalities in such patients The mechanism responsible for this higher incidence in cardiovascular disease is unclear In nondiabetic individuals increased arterial stiffness is important because it leads to increased systolic pressure pulse pressure and decreased diastolic coronary perfusion3 Arterial stiffness is emerging as the most important determinant of increased systolic and pulse pressure in aging populations and is a recognized risk factor for cardiovascular complications such as left ventricular hypertrophy heart failure atherosclerosis of small vessels leading to stroke myocardial infarction and renal failure Arterial stiffness can be evaluated noninvasively by measuring the pulse wave velocity PWV that is the speed at which the arterial pulse travels along the vessel wall It is a fundamental principle that pulse wave travels faster in stiffer arteries and therefore measurement of PWV is a clinical surrogate for the evaluation of stiffness in large arteriesEpidemiologic and clinical studies have shown that increased aortic stiffness determined by the measurement of aortic PWV is an independent marker of cardiovascular risk in the general population4 and that each aortic PWV increase by 1 m/sec was associated with a 39 increase in allcause mortality5 Several pharmacologic doubleblind trials have shown that various antihypertensive treatments have different effects on arterial wall compliance despite a similar effect on blood pressure BP67 Among antihypertensive drugs angiotensinconverting enzyme ACE inhibitors were shown to improve arterial stiffness independently of BP changes89 The aim of the present study was to investigate whether the use of ACE inhibitors may improve arterial stiffness in diabetic normotensive patients using PWV as a surrogate markerWe studied 42 normotensive patients BP ≤140/90 mm Hg with DM type 1 or 2 26 men 16 women mean age 51 ± 12 years Their baseline parameters were compared with those of 15 healthy individuals matched for age and gender The patients had no signs symptoms or history of cardiac or renal failure coronary insufficiency or major diseases other than diabetes mellitus and were selected to be free of proteinuria or diabetic retinopathyPatients were eligible to participate if they were diabetics on stable drug treatment during the study normotensive and agreed to participate in the followup study which was approved by our hospital Ethics Committee Patients with excessive obesity body mass index BMI 40 kg/m2 were excluded to avoid overestimation of PWV


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References

citation title=Different effect of antihypertensive drugs on conduit artery endothelial function citation author=Ghiadoni L citation author=Magagna A citation author=Versari D citation author=Kardasz I citation author=Huang Y citation author=Taddei S citation author=Salvetti A citation journal title=Hypertension citation year=2003 citation volume=41 citation pages=12811286


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Other Papers In This Journal:

  1. Effect of Sodium on Blood Pressure, Cardiac Hypertrophy, and Angiotensin Receptor Expression in Rats
  2. P-470: Cardiovascular risk factors in the elderly. accuracy of attention in primary care
  3. I37AN EXAMPLE OF RESEARCH IN HYPERTENSION IN LATIN AMERICA.
  4. P-132: Chronic cocaine abuse as a cause of left ventricular hypertrophy?
  5. P-405: Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: A prospective angiographic study
  6. P-554: Pulse pressure as a predictor factor for survival in patients with acute ishaemic stroke
  7. P-322: Impact of ambulatory pulse pressure and office pulse pressure on left ventricular hypertrophy in patients with essential hypertension
  8. G19Superiority of 3d VS 2d echocardiography for measurement of left ventricular mass: an in vivo canine anatomic validation.
  9. Role of Sex Steroids in Modulating Tumor Necrosis Factor Alpha-Induced Changes in Vascular Function and Blood Pressure
  10. P-269: Correlation between ascending aortic pressures and outcomes in patients with coronary artery disease
  11. P-403: Effect of short-term supplementation of potassium chloride and potassium citrate on blood pressure in patients with untreated essential hypertension
  12. P-403: Effect of short-term supplementation of potassium chloride and potassium citrate on blood pressure in patients with untreated essential hypertension
  13. G10Cardiovascular reactivity to mental stress task and serum lipid levels in young mildly hypertensive subjects?
  14. Evaluation of antihypertensive therapy with the combination of olmesartan medoxomil and hydrochlorothiazide
  15. G34Effects of a restricted sleep regimen on ambulatory blood pressure monitoring in normotensive subjects
  16. Effect of recombinant human erythropoietin therapy on ambulatory blood pressure in normotensive and in untreated borderline hypertensive hemodialysis patients
  17. Retinol-Binding Protein and Transferrin in UrineNew Markers of Renal Function in Essential Hypertension and White Coat Hypertension?
  18. P-397: Hypertension awareness, control and treatment in rural Mississippi: Morton Have-A-Heart Project
  19. Analysis of the 11β-Hydroxysteroid Dehydrogenase Type 2 Gene (HSD11B2) in Human Essential Hypertension
  20. P-481: Dopaminergic dilatation on cholinergic and electric induced contractions of rat isolated tracheal muscle
  21. P-298: Screening of adolescent hypertension, and evaluation of target organ damages. Results from the Debrecen hypertension study
  22. P-80: Diabetic masked hypertension: risk for stroke in Japanese
  23. Role of Aldosterone in Left Ventricular Hypertrophy in Hypertension
  24. An Extra-adrenal Abdominal Pheochromocytoma Causing Ectopic ACTH Syndrome
  25. P-190: The effect of accupril on circadian blood pressure patterns in hypertensive subjects with left ventricle hypertrophy
  26. P-238: Heart rate variability and ECG changes in 148 Danish patients after two years in the VALUE trial
  27. Re: Heusser et al: elevation of sympathetic activity by eprosartan in young male subjects
  28. G12Reproducibility of two mental stress tasks in subjects with borderline or mild hypertension.
  29. P-272: BP control and CV outcomes in hispanic and nonhispanic women with CAD and hypertension: Findings from invest
  30. P-340: Renal insufficiency is the most prevalent target-organ disease in primary care-attended essential hypertension
  31. P-156: Nitric oxide synthase inhibition mediated afferent and efferent arteriolar vasoconstriction involves L-type calcium channel activation
  32. ADVANCE in the Prevention of Cardiovascular Disease in Diabetic Patients
  33. P-280: Can a generalized transfer function describe the relationship between pressure waveforms in central and upper limb arteries?
  34. Reduction of Vessel Wall Inflammation in Hypertensive Patients: Is Physical Activity the Answer?
  35. P-241: Risk of cardiovascular events with amlodipine, lisinopril, or valsartan therapy in hypertension population
  36. P-357: Incidental renal artery stenosis in heart transplantation: Prevalence and clinical implications
  37. P-439: Hypertension and PLD2 regulation by D5 dopamine receptor
  38. Markers of Inflammation Are Inversely Related to Physical Activity and Fitness in Sedentary Men With Treated Hypertension
  39. P-517: Increased dietary sodium partially blunts the amelioration of insulin resistance induced by dietary potassium supplementation in a neuroendocrine model of visceral obesity
  40. Intrarenal Arterial Network Renin Content and Inhibition by EMD 58265
  41. P-692: 24-hr ambulatory mean blood pressure vs. pulse pressure as a predictor of silent cerebral infarcts in older Japanese hypertensives
  42. Interactions Between Melatonin and Estrogen in the Regulation of Blood Pressure in Women
  43. P-258: Prevalence, awareness, treatment and control of hypertension in Turkey (patent)
  44. B14The Effect Of Calcium And Vitamin D Supplements On Blood Pressure And Calcium Metabolism In Elderly Chinese.
  45. Re: Hawkins RG, Houston MC Is population-wide diuretic use directly associated with the incidence of end-stage renal disease in the United States? A hypothesis. Am J Hypertens. 2005 Jun;18(6):744-9
  46. C36AORTIC DISTENSIBILITY IN NORMOTENSIVE, UNTREATED AND TREATED HYPERTENSIVE PATIENTS.
  47. Erratum
  48. P-325: Impact of medical treatment during one month on systolic blood pressure, left ventricular systolic function and natriuretic peptides in patients with heart failure
  49. Clinical experience with perindopril in African-American hypertensive patients: a large United States community trial
  50. Incremental Expenditure of Treating Hypertension in the United States
  51. Antihypertensive Treatment Alters the Predictive Strength of Pulse Pressure and Other Blood Pressure Measures
  52. Association Between Different measurements of Obesity and the Incidence of Hypertension
  53. P-435: Evaluation of hypertension prevalence and blood pressure goal attainment using data from the 1999–2000 national health and nutrition examination survey (nhanes)
  54. P-140: E-prescription database analysis supports use of combination therapy in hypertensive patients with CAD in invest
  55. P-329: Cardiovascular morbid-mortality in hypertensive patients in relation to the presence of left ventricular hypertrophy. 11 years followed-up cohort
  56. D27COMPARATIVE EFFICACY OF HYDROCHLOROTHIAZIDE AND AMLODIPINE IN ELDERLY SUBJECTS WITH AMBULATORY HYPERTENSION.
  57. Exercise Activates Renal Dysfunction in Hypertension
  58. Myocardial Contrast Echocardiography: An Innovative Technique to Assess Myocardial Perfusion in Hypertensive Patients
  59. P-473: Hypertension in sub-Saharan Africa
  60. C18Relationship Between 24H Urinary Albumin Excretion Rate (Uae), Left Ventricular Mass Index (Lvmi) And 24H Ambulatory Blood Pressure (Abp) In Borderline Hypertensives (Bh) And Normotensive Offspring Of Hypertensive Parents.

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