Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 May;12(5):454-61.
doi: 10.1093/eurjhf/hfq022. Epub 2010 Mar 7.

Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease

Cesare Russo  1 , Zhezhen Jin, Shunichi Homma, Tatjana Rundek, Mitchell S V Elkind, Ralph L Sacco, Marco R Di Tullio
Affiliations

Effect of diabetes and hypertension on left ventricular diastolic function in a high-risk population without evidence of heart disease

Cesare Russo et al. Eur J Heart Fail. 2010 May.

Abstract

Aims: To assess the independent and combined effects of diabetes and hypertension on left ventricular (LV) diastolic function in a community-based cohort at high cardiovascular risk.

Methods and results: Two-dimensional echocardiography was performed in 708 subjects from the Cardiac Abnormalities and Brain Lesions (CABL) study. Peak diastolic early (E) and late (A) transmitral flow, and tissue Doppler-derived early mitral annulus velocity (E') were recorded, and E/A and E/E' ratios were calculated. The population was divided into four groups: those without hypertension or diabetes (HT-/DM-), those with only hypertension (HT), only diabetes (DM), and with hypertension plus diabetes (HT + DM). In multivariate analysis, hypertension and diabetes were independent predictors of worse diastolic function. The coexistence of hypertension and diabetes was associated with greater impairment of diastolic function (higher E/E' ratio than HT-/DM-, HT, or DM, all P < 0.05), independent of covariates. The negative, synergistic effect of hypertension and diabetes on LV diastolic function was present both in lean participants and in overweight/obese ones. An E/E' ratio >15, suggestive of increased LV filling pressure, was found in 2.2% of HT-/DM-, 8.9% of HT, 5.9% of DM, and 14.7% of HT + DM (P < 0.01).

Conclusion: Hypertension and diabetes are independently associated with impaired LV diastolic function, independent of the effect of overweight/obesity and other covariates. Their coexistence results in a negative synergistic effect on LV diastolic mechanics and is associated with higher LV filling pressures than either condition alone.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Prevalence of LV diastolic dysfunction of any grade (A) and of an E/E′ ratio >15 (B) according to the presence of hypertension, diabetes, or both. HT−/DM−: absence of hypertension and diabetes; HT: hypertension only; DM: diabetes only; HT + DM: hypertension and diabetes.
Figure 2
Figure 2
E/E′ ratio (adjusted for age, gender, and heart rate) according to the presence of hypertension, diabetes, or both in patients with body mass index <25 kg/m2 (A) or ≥25 kg/m2 (B). HT−/DM−: absence of hypertension and diabetes; HT: hypertension only; DM: diabetes only; HT + DM: hypertension and diabetes.
See this image and copyright information in PMC

References

    1. Aurigemma GP, Gottdiener JS, Shemanski L, Gardin J, Kitzman D. Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: the Cardiovascular Health Study. J Am Coll Cardiol. 2001;37:1042–1048. - PubMed
    1. Redfield MM, Jacobsen SJ, Burnett JC, Jr, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. J Am Med Assoc. 2003;289:194–202. - PubMed
    1. Palmieri V, Russo C, Palmieri EA, Arezzi E, Pezzullo S, Minichiello S, Martino S, Migliaresi P, Celentano A. Isolated left ventricular diastolic dysfunction: implications for exercise left ventricular performance in patients without congestive heart failure. J Am Soc Echocardiogr. 2006;19:491–498. - PubMed
    1. Garcia MJ, McNamara PM, Gordon T, Kannel WB. Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study. Diabetes. 1974;23:105–111. - PubMed
    1. Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol. 1974;34:29–34. - PubMed

Publication types

MeSH terms