Effect of blood glucose on left ventricular mass in patients with hypertension and type 2 diabetes mellitus

The aim of our prospective study was to evaluate the influence of blood glu cose (BG) on left ventricular mass and diastolic function in patients with hypertension and type 2 diabetes mellitus (DM). Fifty-six hypertensive pati ents with type 2 DM and 26 healthy controls were investigated. They were su bmitted to echocardiography (ECHO) with Doppler and we calculated the mean of their fasting BG values, office blood pressure (OBP), cholesterol and fr actions, and triglycerides during the previous 4 years. The diabetic patien ts were then followed-up for 1 year with OBP, fasting BG, and lipids measur ed every 2 months. After this period, the patients were again submitted to ECHO and in 22 patients (group I [GI]), reductions greater than 10% in left ventricular mass index (LVMI) were observed (122 +/- 35 nu 89 +/- 23 g/m(2 ), P < .01), whereas increases greater than 10% (group II [GII], n = 17) (9 4 +/- 18 <nu> 115 +/- 27 g/m(2), P < .01) or no changes (group III [GIII], n = 17) (98 +/- 16 <nu> 99 +/- 18 g/m2, NS) in LVMI were detected in the re maining patients. The OBP values did not change during the follow-up. In GI the reduction of LVMI was associated with a BG fall from 178 +/- 36 to 147 +/- 30 mg/dL (P < .01) and a correlation was observed between BG and LVMI percent variations (<Delta>) (r = 0.48, P < .01). No important changes in l eft ventricular diastolic function were observed during the follow-up. We c oncluded that the improvement in glycemic control may contribute to LVH reg ression in hypertensive patients with type 2 DM. Am J Hypertens 2000; 13:11 49-1154 (C) 2000 American Journal of Hypertension, Ltd.