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Patients with type 2 diabetes have exaggerated brachial and central exercise blood pressure: Relation to left ventricular relative wall thickness

Citation

Scott, JA and Coombes, JS and Prins, JB and Leano, RL and Marwick, TH and Sharman, JE, Patients with type 2 diabetes have exaggerated brachial and central exercise blood pressure: Relation to left ventricular relative wall thickness, American Journal of Hypertension, 21, (6) pp. 715-721. ISSN 0895-7061 (2008) [Refereed Article]

Copyright Statement

Copyright 2008 American Journal of Hypertension, Ltd.

DOI: doi:10.1038/ajh.2008.166

Abstract

Background: A hypertensive response to exercise has prognostic significance. Patients with type 2 diabetes have vascular abnormalities which may predispose to exaggerated brachial and central blood pressure (BP) during exercise. This study aimed to test this hypothesis and to determine the clinical significance of high exercise BP by examining its relation to left ventricular (LV) mass. Methods: Brachial and central BP were recorded at rest and in response to maximal exercise in 73 diabetic patients (aged 54 10 years) and 73 controls (aged 53 12 years). Brachial BP was recorded using mercury sphygmomanometry and LV mass using 2D-echocardiography. Central BP was estimated by radial tonometry using an exercise-validated generalized transfer function. Results: At rest there were no significant (P > 0.05) differences between groups in brachial or central BP. The diabetic patients had significantly increased exercise brachial systolic BP (SBP: 199 25 mm Hg vs. 185 21 mm Hg; P = 0.002) and central SBP (158 17 mm Hg vs. 149 15 mm Hg; P = 0.002). There was a significantly higher prevalence of an exaggerated exercise BP response (210/105 mm Hg; men and 190/105 mm Hg; women) in the diabetic patients (51% vs. 22%; P < 0.01). Compared with those with normal exercise BP, LV relative wall thickness (RWT) was significantly higher (0.41 0.09 vs. 0.36 0.08; P < 0.05) and LV hypertrophy was more prevalent (35% vs. 16%; P < 0.05) in those with a hypertensive response. After accounting for other confounding variables, exercise central SBP remained independently associated with LV RWT ( = 0.22; P = 0.006). Conclusion: Diabetic patients are more likely to exhibit exaggerated exercise BP. Regardless of disease status, high exercise central SBP may contribute to cardiovascular risk via adverse cardiac remodeling.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
Author:Sharman, JE (Professor James Sharman)
ID Code:61238
Year Published:2008
Web of Science® Times Cited:31
Deposited By:Menzies Institute for Medical Research
Deposited On:2010-03-02
Last Modified:2014-05-28
Downloads:0

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