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January 1, 2002Hypertension ResearchOpen Access

Fasting plasma glucose ≥100 mg/dl was associated with a significantly higher A/E ratio (1.29 vs 1.11, p=0.001) compared to <100 mg/dl in nondiabetic patients with treated essential hypertension, indicating impaired left ventricular diastolic function.

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Why the study?

Does mildly elevated fasting plasma glucose correlate with left ventricular diastolic dysfunction in nondiabetic patients with treated essential hypertension?

Population

193 nondiabetic patients with treated essential hypertension. Excluded: secondary hypertension, ischemic…

Comparison

Fasting plasma glucose ≥100 mg/dl and <126 mg/dl vs Fasting plasma glucose (FPG) <100 mg/dl

Design

Cross-sectional, Echocardiographic parameters were measured by two experienced…

Key result

Fasting plasma glucose ≥100 mg/dl was associated with a significantly higher A/E ratio (1.29 vs 1.11, p=0.001) compared to <100 mg/dl in nondiabetic patients with treated essential hypertension, indicating impaired left ventricular diastolic function.

Authors

JMJunko MiyazatoTHTakeshi HorioSTShuichi Takishita

Discussion

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Overview

Hypothesis-generating for mild hyperglycemia as diastolic dysfunction marker in treated hypertension; prospective studies needed before any practice implications.

Key Points

  • This study aims to evaluate how mild glucose metabolism abnormalities influence left ventricular structure and function in nondiabetic patients with essential hypertension.
  • Conducted echocardiographic examinations on 193 nondiabetic patients with treated essential hypertension.
  • Assessed correlations between fasting plasma glucose, HbA1c levels, and various echocardiographic parameters.
  • Performed multiple regression analysis to identify independent determinants of the A/E ratio.
  • Fasting plasma glucose levels showed significant correlation with the A/E ratio and deceleration time of E wave.
  • Patients with fasting plasma glucose ≥100 mg/dl exhibited higher peak A wave velocity and A/E ratio compared to those with lower levels.
  • Only fasting plasma glucose and age were independent determinants of the A/E ratio in regression analysis.

Study Design

Type

Cross-Sectional (n=193)

Structured PICO

Does mildly elevated fasting plasma glucose correlate with left ventricular diastolic dysfunction in nondiabetic patients with treated essential hypertension?

P
Population
193 nondiabetic adults (mean age 60) with treated essential hypertension were evaluated in a retrospective cross-sectional study to assess the impact of mild fasting plasma glucose elevation on left ventricular diastolic function.
E
Exposure
Fasting plasma glucose (FPG) ≥100 mg/dl and <126 mg/dl (mildly impaired glucose metabolism)
C
Comparator
Fasting plasma glucose (FPG) <100 mg/dl
O
Outcome
Left ventricular diastolic function assessed by Doppler echocardiography (specifically the ratio of peak velocity of atrial filling to early diastolic filling [A/E ratio])surrogate

Main Result

Absolute Event Rate: 1.29% vs 1.11%

p-value: p=0.001

Mild elevations in fasting plasma glucose are independently associated with left ventricular diastolic dysfunction in nondiabetic hypertensive patients, independent of left ventricular hypertrophy.

Limitations

  • Retrospective study design
  • Indirect estimate of left ventricular diastolic function using Doppler echocardiography
  • Potential confounding influence of various antihypertensive agents on cardiac structure, function, or glucose tolerance
  • Doppler echocardiographic measurements provide only an indirect estimate of LV diastolic function
  • Potential influence of various antihypertensive agents on cardiac structure/function and glucose tolerance

Cite This Study

Miyazato et al. (2002) conducted a cross-sectional in Treated essential hypertension (n=193). Fasting plasma glucose ≥ 100 mg/dl vs. Fasting plasma glucose < 100 mg/dl was evaluated on A/E ratio (peak velocity ratio of atrial filling to early diastolic filling) (p=0.001). Fasting plasma glucose ≥100 mg/dl was associated with a significantly higher A/E ratio (1.29 vs 1.11, p=0.001) compared to <100 mg/dl in nondiabetic patients with treated essential hypertension, indicating impaired left ventricular diastolic function.

synapsesocial.com/papers/6a6e7d74f44fa9f079dc31bfhttps://doi.org/10.1291/hypres.25.403
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Plasma Glucose Levels and Left Ventricular Diastolic Function in Nondiabetic Hypertensive Patients2013 · 29 citations
  2. 2Left ventricular hypertrophy and preclinical impaired glucose tolerance and diabetes mellitus contribute to abnormal left ventricular diastolic function in hypertensive patients2005 · 9 citations
  3. 3Role of glucose intolerance in cardiac diastolic function in essential hypertension.1994 · 37 citations
  4. 4One-Hour Postload Plasma Glucose Levels and Diastolic Function in Hypertensive Patients2011 · 46 citations
  5. 5Left Ventricular Diastolic Function in Hypertension and Role of Plasma Glucose and Insulin1996 · 82 citations