WorldWideScience

Sample records for hypertension og diabetes

  1. Hypertension og diabetes mellitus

    DEFF Research Database (Denmark)

    Poulsen, Per; Hansen, Klavs; Gæde, Peter

    2009-01-01

    The documentation for the beneficial effects of antihypertensive treatment in patients with diabetes is overwhelming. Most patients will require three or four antihypertensive drugs to achieve blood pressure (BP) goals. The regime should include an agent that blocks the renin angiotensin aldoster......The documentation for the beneficial effects of antihypertensive treatment in patients with diabetes is overwhelming. Most patients will require three or four antihypertensive drugs to achieve blood pressure (BP) goals. The regime should include an agent that blocks the renin angiotensin...

  2. Hypertension og diabetes mellitus

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Hansen, Klavs Würgler; Gaede, Peter Haulund

    2009-01-01

    The documentation for the beneficial effects of antihypertensive treatment in patients with diabetes is overwhelming. Most patients will require three or four antihypertensive drugs to achieve blood pressure (BP) goals. The regime should include an agent that blocks the renin angiotensin aldoster...

  3. Hypertension og diabetes mellitus

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Hansen, Klavs Würgler; Gaede, Peter Haulund

    2009-01-01

    The documentation for the beneficial effects of antihypertensive treatment in patients with diabetes is overwhelming. Most patients will require three or four antihypertensive drugs to achieve blood pressure (BP) goals. The regime should include an agent that blocks the renin angiotensin...... aldosterone system. Reduction in albuminuria during antihypertensive treatment is indicative of renal and cardiovascular protection. Thus, if the level of albuminuria remains high, the treatment should be intensified, even in the light of achieved BP goals. Options for intensification are dual blockade...

  4. Genetik og hypertension

    DEFF Research Database (Denmark)

    Ellervik, Christina; Tarnow, Lise; Pedersen, Erling Bjerregaard

    2009-01-01

    Monogenic forms of hypertension are very rare, but have a well-characterized heredity. Primary hypertension is very common with a complex and polygenic heredity. Primary hypertension arises due to an interaction between multiple genetic and environmental factors. Its heredity is unknown, although...

  5. Hypertension og hyperlipidaemi

    DEFF Research Database (Denmark)

    Hansen, Henrik Steen; Larsen, Mogens Lytken

    2009-01-01

    Hypertension and hyperlipidemia are well-established and partially overlapping risk factors for cardiovascular disease. Analyses of cardiovascular morbidity in relationship to changes in blood pressure and in serum cholesterol levels have shown that combined reduction of both risk factors...... are important to achieve a reduction in morbidity. Statins have been shown to be effective in preventing both coronary and cerebrovascular events in both hypertensive and normotensive cases. Consequently, most recent guidelines recommend that statin treatment be considered in hypertensive patients aged less...

  6. Hypertension og hjernen

    DEFF Research Database (Denmark)

    Christensen, Hanne; Strandgaard, Svend

    2009-01-01

    Hypertension is a major and modifiable risk factor of stroke and dementia. Hypertension causes remodelling of the cerebral resistance vessels, impairing their tolerance to very low blood pressure. In primary prevention of stroke, the effect of beta-blockers is inferior to other classes...

  7. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  8. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive......Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  9. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  10. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice. Udgivelsesdato: 2009-Jun-15...

  11. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Svendsen, Tage Lysbo; Andersen, Niels Holmark

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  12. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  13. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Andersen, Niels Holmark; Svendsen, Tage Lysbo

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...... substantial reductions in incident heart failure. In addition, the authors suggest that atrial fibrillation should be considered target organ damage with the resulting implications in terms of blood pressure reduction in guidelines, and that modern treatment of atrial fibrillation should also include...

  14. Barn og diabetes type 1

    OpenAIRE

    Ramstad, Marte Elise; Sagbakken, Sina Bekkelund

    2017-01-01

    Bacheloroppgave sykepleie, 2017 Bakgrunn: Vi har valgt denne problemstillingen fordi diabetes type 1 er svært utbredt hos barn i Norge. Videre har vi lite erfaringer med barn og ønsket å lære mer om denne pasientgruppen. Vi ønsket videre å se på hvordan vi kan undervise og veilede for å gi god og hensiktsmessig sykepleie til barn og deres familier. Hensikt: Finne ut hvordan sykepleier kan fremme egenomsorg hos barn med diabetes gjennom veiledning og undervisning. Dette er noe som sykepl...

  15. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...

  16. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael; Jeppesen, Jørgen; Larsen, Mogens

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun-15...

  17. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun...

  18. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over ...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates....

  19. Diabetes mellitus type 2 - erfaringer og mestring

    OpenAIRE

    Onstad, Christine; Fiskå, Helene Sæth

    2016-01-01

    Bakgrunn: Forekomsten av diabetes mellitus øker dramatisk i hele verden, og representerer en stor utfordring for menneskene med diabetes og helsevesenet. I Norge er det antagelig rundt 350 000 til 400 000 personer med diabetes, hvorav 90% har diabetes mellitus type 2.

  20. Genomet og diabetes

    DEFF Research Database (Denmark)

    Allin, Kristine Højgaard; Hansen, Torben; Pedersen, Oluf Borbye

    2014-01-01

    In terms of their genetic architecture monogenic diabetes and type 2 diabetes represent two extremes. Whereas each subtype of monogenic diabetes is caused by one penetrant, rare mutation in a single gene, the genetic susceptibility to type 2 diabetes can be attributed to many low-penetrant variants...... across the genome. At present, only 10% of the genetic susceptibility to type 2 diabetes can be explained by the hitherto identified 90 genomic loci. Here we briefly review the genetics of monogenic diabetes and type 2 diabetes and outline future directions of research within this field....

  1. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over ...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates. Udgivelsesdato: 2009-Jun-8...

  2. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... risk associated with increased blood pressure. As the definition of the metabolic syndrome is based on dichotomization of cardiovascular risk factors with a continuously increasing risk, it cannot match risk stratification tools like the HeartScore for calculation of prognosis. However, the metabolic...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun-15...

  3. Intraabdominal hypertension og abdominalt kompartmentsyndrom

    DEFF Research Database (Denmark)

    Sonne, Morten; Hillingsø, Jens

    2008-01-01

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...

  4. Kost, diabetes mellitus og parodontal inflammation

    DEFF Research Database (Denmark)

    Damgaard, Christian; Holmstrup, Palle

    2017-01-01

    Nærværende artikel præsenterer en oversigt over den foreliggende viden om kostens betydning for diabetes mellitus (DM) og parodontal inflammation. Der er i vekslende grad dokumentation for sammenhænge mellem kost, DM og marginal parodontitis (MP). Med baggrund i forøget viden om kostens betydning...... for udviklingen af henholdsvis DM og parodontal inflammation bør tandlæger også rådgive om kost for derigennem at styrke behandlingen af patienter med MP og DM....

  5. Kost, diabetes mellitus og parodontal inflammation

    DEFF Research Database (Denmark)

    Damgaard, Christian; Holmstrup, Palle

    2016-01-01

    Nærværende artikel præsenterer en oversigt over den foreliggende viden om kostens betydning for diabetes mellitus (DM) og parodontal inflammation. Der er i vekslende grad dokumentation for sammenhænge mellem kost, DM og marginal parodontitis (MP). Med baggrund i forøget viden om kostens betydning...... for udviklingen af henholdsvis DM og parodontal inflammation bør tandlæger også rådgive om kost for derigennem at styrke behandlingen af patienter med MP og DM....

  6. Kost, diabetes mellitus og parodontal inflammation

    DEFF Research Database (Denmark)

    Damgaard, Christian; Holmstrup, Palle

    2017-01-01

    Nærværende artikel præsenterer en oversigt over den foreliggende viden om kostens betydning for diabetes mellitus (DM) og parodontal inflammation. Der er i vekslende grad dokumentation for sammenhænge mellem kost, DM og marginal parodontitis (MP). Med baggrund i forøget viden om kostens betydning...

  7. Diabetes + Hypertension (comorbidity)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set provides de-identified population data for diabetes and hypertension comorbidity prevalence in Allegheny County.

  8. Knowing hypertension and diabetes

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2016-01-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology for diagnos......In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology...... for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy...

  9. Management of diabetic hypertensives

    Directory of Open Access Journals (Sweden)

    Jai Ganesh

    2011-01-01

    Full Text Available Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives.

  10. Hypertension with diabetes mellitus complications.

    Science.gov (United States)

    Yamazaki, Daisuke; Hitomi, Hirofumi; Nishiyama, Akira

    2018-01-22

    Chronic diabetic complications are classified as microvascular or macrovascular and contribute to mortality and loss of quality of life. Hyperglycemia plays a critical role in the pathogenesis of microvascular complications, such as diabetic retinopathy, incipient nephropathy, and neuropathy, while atherosclerosis contributes to the pathogenesis of macrovascular complications. Diabetes mellitus and hypertension are frequently present together. Among many microvascular diabetic complications, hypertension plays a predominant role in the progression of diabetic nephropathy by glomerular hyperfiltration. Hypertension also induces atherosclerosis in diabetes. Thus, hypertension is a high-risk factor for both microvascular and macrovascular chronic diabetic complications. In this review, we summarize the current knowledge on the pathophysiological mechanisms of microvascular and macrovascular chronic diabetic complications with particular emphasis on the contribution of hypertension. We also briefly discuss various options available for the treatment of each diabetic complication.

  11. In situ bypass og diabetes

    DEFF Research Database (Denmark)

    Jensen, Leif Panduro; Schroeder, T V; Lorentzen, J E

    1993-01-01

    From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p...... decreased survival rate was found in diabetics (p bypass technique very useful in the treatment of critical ischaemia of the lower limb in diabetic patients. The overall results in diabetic patients, whether insulin-dependent or not, were equal to those in non...

  12. What is hypertension in diabetes?

    DEFF Research Database (Denmark)

    Hansen, K W; Poulsen, P L; Ebbehøj, E

    2001-01-01

    AIMS: To establish reference data for ambulatory blood pressure (AMBP) in normotensive, normoalbuminuric Type 1 diabetic patients and characterize the relation to clinic blood pressure (BP). To evaluate the statement of the third working party of the British Hypertension Society (BHS) that a target...... clinic BP in diabetes hypertensive drugs. Clinic BP was determined as the mean of at least three auscultatory...

  13. Lakridsinduceret hypertension og hypokaliæmi

    DEFF Research Database (Denmark)

    Nielsen, Mette Lundgren; Pareek, Manan; Andersen, Inger

    2012-01-01

    Consumption of large amounts of liquorice can cause hypertension and hypokalaemia. Liquorice contains glycyrrhetinic acid, which inhibits the enzyme 11 beta-hydroxysteroid dehydrogenase type 2, and ultimately leads to an apparent mineralocorticoid excess syndrome. This case report describes a 50...... year-old woman presenting with hypertension and hypokalaemia-induced limb paresis due to chronic liquorice ingestion. The patient was treated with potassium supplementation and spironolactone. Her blood pressure and electrolyte status normalised within a month after cessation of liquorice intake....

  14. Masked Hypertension in Diabetes Mellitus

    Science.gov (United States)

    Franklin, Stanley S.; Thijs, Lutgarde; Li, Yan; Hansen, Tine W.; Boggia, José; Liu, Yanping; Asayama, Kei; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Torp-Pedersen, Christian; Dolan, Eamon; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Filipovský, Jan; Imai, Yutaka; Wang, Jiguang; Ibsen, Hans; O’Brien, Eoin; Staessen, Jan A.

    2013-01-01

    Although distinguishing features of masked hypertension in diabetics are well known, the significance of antihypertensive treatment on clinical practice decisions has not been fully explored. We analyzed 9691 subjects from the population-based 11-country International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes. Prevalence of masked hypertension in untreated normotensive participants was higher (Phypertensives tended to be higher than in normotensives (hazard rate [HR], 1.96; 95% confidence interval [CI], 0.97–3.97; P=0.059), similar to untreated stage 1 hypertensives (HR, 1.07; CI, 0.58–1.98; P=0.82), but less than stage 2 hypertensives (HR, 0.53; CI, 0.29–0.99; P=0.048). In contrast, cardiovascular risk was not significantly different in antihypertensive-treated diabetic-masked hypertensives, as compared with the normotensive comparator group (HR, 1.13; CI, 0.54–2.35; P=0.75), stage 1 hypertensives (HR, 0.91; CI, 0.49–1.69; P=0.76), and stage 2 hypertensives (HR, 0.65; CI, 0.35–1.20; P=0.17). In the untreated diabetic-masked hypertensive population, mean conventional systolic/diastolic blood pressure was 129.2±8.0/76.0±7.3 mm Hg, and mean daytime systolic/diastolic blood pressure 141.5±9.1/83.7±6.5 mm Hg. In conclusion, masked hypertension occurred in 29% of untreated diabetics, had comparable cardiovascular risk as stage 1 hypertension, and would require considerable reduction in conventional blood pressure to reach daytime ambulatory treatment goal. Importantly, many hypertensive diabetics when receiving antihypertensive therapy can present with normalized conventional and elevated ambulatory blood pressure that mimics masked hypertension. PMID:23478096

  15. Type 2-diabetes. Sociale relationer og sundhedsadfaerd

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Andersen, Anne Friis; Avlund, Kirsten

    2008-01-01

    thoroughly based on Danish data. The purpose of this study was to examine the association between social relations and health behaviour among adult Danes with type 2 diabetes. MATERIALS AND METHODS: The study design was cross-sectional and based on data from the report ''Sundheds- og Sygelighedsundersøgelsen......INTRODUCTION: Type 2 diabetes is a chronic disease that challenges the Danish health care system and health behaviour is important in connection with rehabilitation. Foreign research shows that social relations are associated with a healthy lifestyle, but this effect has not yet been examined...... 2000'', published by The National Institute of Public Health; 264 respondents with type 2 diabetes were included in the final study population. Social relations were measured in terms of civil status, social contact and functional network. Health behaviour reflects whether the respondents comply...

  16. Type 2-diabetes. Sociale relationer og sundhedsadfaerd

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Andersen, Anne Friis; Avlund, Kirsten

    2008-01-01

    INTRODUCTION: Type 2 diabetes is a chronic disease that challenges the Danish health care system and health behaviour is important in connection with rehabilitation. Foreign research shows that social relations are associated with a healthy lifestyle, but this effect has not yet been examined...... thoroughly based on Danish data. The purpose of this study was to examine the association between social relations and health behaviour among adult Danes with type 2 diabetes. MATERIALS AND METHODS: The study design was cross-sectional and based on data from the report ''Sundheds- og Sygelighedsundersøgelsen...... 2000'', published by The National Institute of Public Health; 264 respondents with type 2 diabetes were included in the final study population. Social relations were measured in terms of civil status, social contact and functional network. Health behaviour reflects whether the respondents comply...

  17. Masked hypertension in diabetes mellitus

    DEFF Research Database (Denmark)

    Franklin, Stanley S; Thijs, Lutgarde; Li, Yan

    2013-01-01

    Although distinguishing features of masked hypertension in diabetics are well known, the significance of antihypertensive treatment on clinical practice decisions has not been fully explored. We analyzed 9691 subjects from the population-based 11-country International Database on Ambulatory Blood...... Pressure in Relation to Cardiovascular Outcomes. Prevalence of masked hypertension in untreated normotensive participants was higher (P...

  18. Determinants of isolated systolic hypertension among diabetic ...

    African Journals Online (AJOL)

    Background: Hypertension and diabetes mellitus, two of the leading risk factors for atherosclerosis, are associated with numerous complications, including heart attacks and strokes. Aim: This study established the prevalence and determinants of isolated systolic hypertension (ISH) in diabetes mellitus patients visiting the ...

  19. Managing hypertension in type 2 diabetes mellitus.

    Science.gov (United States)

    Horr, Samuel; Nissen, Steven

    2016-06-01

    Hypertension is a common problem in the diabetic population with estimates suggesting a prevalence exceeding 60%. Comorbid hypertension and diabetes mellitus are associated with high rates of macrovascular and microvascular complications. These two pathologies share overlapping risk factors, importantly central obesity. Treatment of hypertension is unequivocally beneficial and improves all-cause mortality, cardiovascular mortality, major cardiovascular events, and microvascular outcomes including nephropathy and retinopathy. Although controversial, current guidelines recommend a target blood pressure in the diabetic population of diabetes. Management of blood pressure in patients with diabetes includes both lifestyle modifications and pharmacological therapies. This article reviews the evidence for management of hypertension in patients with type 2 diabetes mellitus, and provides a recommended treatment strategy based on the available data. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Glutaminsyre-decarboxylase-antistoffer og diabetes

    DEFF Research Database (Denmark)

    Mandrup-Poulsen, Thomas

    2007-01-01

    The 1999 WHO classification delineates immune mediated type 1 diabetes from other types of diabetes by the presence of auto-antibodies against beta-cell constituents. The GAD65 auto-antibody test is the method of first choice because it has the highest sensitivity, specificity and positive...... predictive value and is the most standardized and well-characterized type 1 diabetes related auto-antibody analysis. It is recommended that demonstration of GAD auto-antibodies leads to diagnosis, classification or re-classification of diabetes patients as immune mediated type 1 diabetes. Udgivelsesdato...

  1. Management issues in hypertensive diabetics | Thaver | South ...

    African Journals Online (AJOL)

    This article discusses seven issues in the management of hypertension in diabetic patients, namely the importance of blood pressure control, optimal blood pressure control levels, the importance of blocking the renin-angiotensin system, the inevi-tability of combination anti-hypertensive therapy, drug choices, the ...

  2. Kombination af aliskiren og losartan hos patienter med type 2-diabetes og nefropati - Sekundaerpublikation

    DEFF Research Database (Denmark)

    Parving, Hans-Henrik; Persson, Frederik; Lewis, Julia B

    2009-01-01

    We evaluated the renoprotective effects of adding aliskiren to treatment with losartan in hypertensive patients with type 2 diabetes and nephropathy. A total of 599 patients were randomized to six months of treatment with placebo or aliskiren in addition to losartan 100 mg and optimal...

  3. CO-OCCURRENCE OF DIABETES AND HYPERTENSION ...

    African Journals Online (AJOL)

    INTRODUCTION. Diabetes and hypertension are two non-communicable diseases that frequently co-exist. Several studies have shown that raised blood pressure is commoner among people with diabetes than in the general population.1-3. Both diseases are independent risk factors for cardiovascular disease (CVD), and ...

  4. Type 2-diabetes. Sociale relationer og sundhedsadfaerd

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Andersen, Anne Friis; Avlund, Kirsten

    2008-01-01

    INTRODUCTION: Type 2 diabetes is a chronic disease that challenges the Danish health care system and health behaviour is important in connection with rehabilitation. Foreign research shows that social relations are associated with a healthy lifestyle, but this effect has not yet been examined...... to the recommendations for physical activity and diet. Only the association between functional network and diet remains significant when adjusted for the effects of co-variates. CONCLUSION: The study shows a need for the promotion of health behaviour among adult Danes with type 2 diabetes, and indicates that social...

  5. Fod- og ankeltraume hos patient med diabetes

    DEFF Research Database (Denmark)

    Falborg, Bettina; Ebskov, Lars

    2009-01-01

    treatment of sprains and fractures with immobilisation and a non-weight bearing period is significantly prolonged, frequently doubled, in diabetic patients. Follow-up includes frequent ambulatory controls including X-rays. If the neuroarthropathy progresses, the period of treatment is adjusted accordingly....

  6. Prognostisk betydning af "white coat" og maskeret hypertension

    DEFF Research Database (Denmark)

    Gustavsen, Pia; Hansen, Tine Willum

    2009-01-01

    The growing use of ambulatory blood pressure monitoring has led to an increased awareness of the two types of discrepancy between office blood pressure and ambulatory blood pressure, called white coat hypertension (WCH) and masked hypertension (MH). Based on several longitudinal studies, WCH...

  7. Type 2-diabetes. Sociale relationer og sundhedsadfaerd

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Andersen, Anne Friis; Avlund, Kirsten

    2008-01-01

    with the official Danish recommendations for physical activity, diet, alcohol and smoking. Adjustments were made for sex, age, income, self-rated health, functional ability, stress and Body Mass Index. RESULTS: Social relations measured as civil status and functional network are positively associated with adherence...... to the recommendations for physical activity and diet. Only the association between functional network and diet remains significant when adjusted for the effects of co-variates. CONCLUSION: The study shows a need for the promotion of health behaviour among adult Danes with type 2 diabetes, and indicates that social...

  8. Fod- og ankeltraume hos patient med diabetes

    DEFF Research Database (Denmark)

    Falborg, Bettina; Ebskov, Lars

    2009-01-01

    If confronted with a neuropathic patient with an acute foot-ankle trauma, including fracture, this patient is by definition Eichenholtz stage 0. This is of major importance for the treatment. Whereas the surgical handling of fractures does not differ from ordinary fracture treatment, the subsequent...... treatment of sprains and fractures with immobilisation and a non-weight bearing period is significantly prolonged, frequently doubled, in diabetic patients. Follow-up includes frequent ambulatory controls including X-rays. If the neuroarthropathy progresses, the period of treatment is adjusted accordingly....

  9. Fod- og ankeltraume hos patient med diabetes

    DEFF Research Database (Denmark)

    Falborg, Bettina; Ebskov, Lars

    2009-01-01

    If confronted with a neuropathic patient with an acute foot-ankle trauma, including fracture, this patient is by definition Eichenholtz stage 0. This is of major importance for the treatment. Whereas the surgical handling of fractures does not differ from ordinary fracture treatment, the subsequent...... treatment of sprains and fractures with immobilisation and a non-weight bearing period is significantly prolonged, frequently doubled, in diabetic patients. Follow-up includes frequent ambulatory controls including X-rays. If the neuroarthropathy progresses, the period of treatment is adjusted accordingly...

  10. Clinical Observation on Hypertension in Diabetes Mellitus(Hypertension : Pathophysiology and Treatment)

    OpenAIRE

    奈良, 芳則; 尾崎, 信紘; 山田, 彬; 浜, 斉; 谷, 長行; Nara, Yoshinori; Ozaki, Nobuhiro; Yamada, Akira; Hama, Hitoshi; Tani, Nagayuki

    1989-01-01

    The incidence of hypertension is approximately twice as common in patients with diabetes mellitus as it is in those without. Both hypertension and diabetes mellitus are major risk factors for arteriosclerotic diseases (cerebral infarction, cardiovascular disease etw). A positive correlation exists between the presence of hypertension and retinopathy or nephropathy in patients with diabetes mellitus. This article provides practical approach in the management of hypertension with diabetes melli...

  11. Hypertension In Type II Diabetes Mellitus In Jos University Teaching ...

    African Journals Online (AJOL)

    ... with hypertension in diabetes. Conclusion: Hypertension is commoner in diabetes in sub-saharan Africa that it was previously believed. The finding of hypertension should arouse the possibility of the presence of microangiopathic complications in type II diabetes. Highland Medical Research Journal Vol.1(2) 2002: 22-24 ...

  12. Determinants of isolated systolic hypertension among diabetic ...

    African Journals Online (AJOL)

    type 1 and type 2) in Ghana and worldwide. This study, therefore, sought to determine the prevalence and deter- minants of isolated systolic hypertension among diabetes patients in the Tamale metropolis of Ghana. Materials and methods. Study design/ study site. This purposive cross-sectional study was conducted from.

  13. Diabetes and hypertension screening in Zandspruit, Johannesburg ...

    African Journals Online (AJOL)

    Paul Rheeder

    2016-06-29

    Jun 29, 2016 ... Keywords: diabetes mellitus, hypertension, obesity, screening, South Africa. Background. According to WHO ... Africa, China, Ghana, India, Mexico and Russia, found that 78% of those who took part in South ... adults of any age who are overweight or obese (BMI ≥ 25 kg/m2) and who have one or more ...

  14. Missed medical appointment among hypertensive and diabetic ...

    African Journals Online (AJOL)

    Purpose: To explore the reasons for missed medical appointment, patients' awareness on its consequences; and to find strategies to reduce it among the study population. Methods: This was a descriptive cross-sectional survey among 300 hypertensive and 200 diabetic outpatients assessing care at the University College ...

  15. Missed medical appointment among hypertensive and diabetic ...

    African Journals Online (AJOL)

    include forgetfulness, lack of funds for transport, conflicting commitments, etc. The level of awareness on the possible impact of ... Chronic diseases such as hypertension and diabetes require lifelong commitment to medication ..... pertaining to claims relating to the content of this article will be borne by them. Open Access.

  16. Prenatally programmed hypertension: role of maternal diabetes

    Directory of Open Access Journals (Sweden)

    G.N. Gomes

    2011-09-01

    Full Text Available Epidemiological and experimental studies have led to the hypothesis of the fetal origin of adult diseases, suggesting that some adult diseases might be determined before birth by altered fetal development. Maternal diabetes subjects the fetus to an adverse environment that has been demonstrated to result in metabolic, cardiovascular and renal impairment in the offspring. The growing amount of obesity in young females in developed and some developing countries should contribute to increasing the incidence of diabetes among pregnant women. In this review, we discuss how renal and extrarenal mechanisms participate in the genesis of hypertension induced by a diabetic status during fetal development.

  17. Spirapril og nitrendipin ved arteriel hypertension. Sammenligning af behandlingseffekt og tolerabilitet

    DEFF Research Database (Denmark)

    Carlsen, J E; Galløe, A; Leikersfeldt, G

    1990-01-01

    In a double-blind, randomized parallel-group investigation, a new angiotensin-converting enzyme-inhibitor, spirapril, was compared with a calcium antagonist, nitrendipine, in 266 patients with mild to moderate hypertension (diastolic blood pressure 96-119 mmHg). The object was to reduce the diast...

  18. Treating the Diabetic Hypertensive: Consensus and Differences

    Directory of Open Access Journals (Sweden)

    Abdul Rashid Rahman

    2016-07-01

    Full Text Available Hypertension and diabetes commonly coexist. Both are major modifiable risk factors for cardiovascular diseases. There has been a substantial shift in the recommendations of several expert committees on the management of hypertension in diabetics. It was once unanimously agreed by almost all major guidelines that the threshold for initiating diabetic patients with antihypertensive therapy is when blood pressure is >130/80 mmHg. The blood pressure target for treatment was also unanimously agreed to be <130/80 mmHg. These recommendations were, however, based on expert opinions and not on findings from major randomised controlled trials. Since then, there have been several randomised controlled trials looking at blood pressure-lowering in the diabetic population. These include the ADVANCE and ACCORD, and a subanalysis of the INVEST trials. Together with the earlier UKPDS and HOT trials, one would expect there to be more agreement in the most recent recommendations, but in fact the opposite is the case. There are now two different systolic targets (<130 mmHg and <140 mmHg and three different diastolic targets (<90 mmHg, 85 mmHg, and <80 mmHg. The reason for this involves the choice of trials included in the recommendation, and the interpretation of results from these trials by various guideline committees. The recommendation for diabetic hypertensives will be more consistent if future trials begin by asking a relevant research question that has not yet been answered: does treating diabetics with different thresholds of blood pressure levels impact on clinical outcomes? The trial must not only determine a primary research question, but it must also be adequately powered to answer it. Only when this question is answered should the next questions be asked. Does it matter how blood pressure is lowered? And are some drugs better than others? In the meantime, guideline committees should try to narrow the gap in recommendations, particularly if the

  19. Prevalence of hypertension amongst persons with diabetes mellitus ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hypertension amongst persons with diabetes mellitus (DM) in Benin city. Materials and Methods: Four hundred and fifty diabetic subjects were evaluated for hypertension by measuring their blood pressure using a sphygmomanometer at the diabetes clinics of the University of Benin ...

  20. Which increases depressive symptoms in obese patients, hypertension or diabetes?

    Directory of Open Access Journals (Sweden)

    Sakir Özgür Keskek

    2013-04-01

    Full Text Available Background: Depression and obesity are common disorders. Obesity is also predictive of several chronic diseases like hypertension and diabetes. The aim of this study was to evaluate and compare depression frequency of obese patients with hypertension or diabetes. Methods: Weight, height and body mass index (BMI were measured. The definition of obesity was a body mass index (weight (kg/height (m2 ≥30 kg/m2. Obese patients with hypertension or diabetes were documented. All participants had a Beck Depression Inventory (BDI evaluation. Results: A total of 389 subjects were included, of whom 100, 101, 92, 96 participants were healthy, obese, obese with hypertension, obese with diabetes, respectively. Beck Depression Inventory scores of obese patients, obese patients with hypertension or diabetes were higher compared to the control group. BDI scores of obese patients with diabetes were higher compared to obese and obese with hypertension subjects.

  1. Streptozotocin-induced diabetes mellitus in spontaneously hypertensive rats: a pathophysiological model for the combined effects of hypertension and diabetes

    NARCIS (Netherlands)

    Pijl, A. J.; van der Wal, A. C.; Mathy, M. J.; Kam, K. L.; Hendriks, M. G.; Pfaffendorf, M.; van Zwieten, P. A.

    1994-01-01

    The present study was undertaken to investigate the combined effects of hypertension and streptozotocin-induced diabetes mellitus in the rat. Accordingly, four groups of rats were studied: Wistar Kyoto rats (WKY), diabetic WKY, spontaneously hypertensive rats (SHR) and diabetic SHR, respectively.

  2. Type 2 diabetes mellitus and hypertension: an update.

    Science.gov (United States)

    Lastra, Guido; Syed, Sofia; Kurukulasuriya, L Romayne; Manrique, Camila; Sowers, James R

    2014-03-01

    Patients with hypertension and type 2 diabetes are at increased risk of cardiovascular and chronic renal disease. Factors involved in the pathogenesis of both hypertension and type 2 diabetes include inappropriate activation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, impaired insulin-mediated vasodilatation, augmented sympathetic nervous system activation, altered innate and adaptive immunity, and abnormal sodium processing by the kidney. The renin-angiotensin-aldosterone system blockade is a key therapeutic strategy in the treatment of hypertension in type 2 diabetes. Emerging therapies for resistant hypertension as often exists in patients with diabetes, include renal denervation and carotid body denervation. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Vascular function in health, hypertension, and diabetes

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Gliemann, Lasse; Hellsten, Ylva

    2015-01-01

    muscle, which can affect muscle function. Central aspects in the vascular impairments are alterations in the formation of prostacyclin, the bioavailability of NO and an increased formation of vasoconstrictors and reactive oxygen species (ROS). Regular physical activity effectively improves vascular...... to the formation of vasodilators such as nitric oxide (NO) and prostacyclin. In essential hypertension and type II diabetes, the endothelial function and regulation of vascular tone is impaired with consequent increases in peripheral vascular resistance and inadequate regulation of oxygen supply to the skeletal...

  4. Serum lipid profile in diabetic and hypertensive Nigerian subjects ...

    African Journals Online (AJOL)

    ... to compare the serum lipid profile of diabetic and hypertensive subjects resident in Kano metropolis and to evaluate their pattern and probable disposition to atherosclerosis and coronary heart disease. ... Results: Hypertensive subjects had higher mean serum TC, HDL-CH, BMI and BP values that diabetic subjects.

  5. Peptide Vaccines for Hypertension and Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Hironori Nakagami

    2014-11-01

    Full Text Available Vaccines are commonly used as a preventive medicine for infectious diseases worldwide; however, the trial for an amyloid beta vaccine against Alzheimer’s disease will open a new concept in vaccination. In case of therapeutic vaccines for cancer, their targets are usually specific antigens in cancer cells, allowing activated cytotoxic T cells (CTLs to attach and remove the antigen-presenting cancer cells. In our therapeutic vaccines against hypertension, the target is angiotensin II (Ang II and induced anti-Ang II antibodies could efficiently ameliorate high blood pressure. Similarly, we developed the therapeutic vaccine against DPP4 for diabetes mellitus. However, because Ang II or DPP4 is an endogenous hormone, we must avoid autoimmune disease induced by these vaccines. Therefore, our system was used to design a therapeutic vaccine that elicits anti-Ang II or DPP4 antibodies without CTL activation against Ang II or DPP4. In this review, we will describe our concept of therapeutic vaccines for hypertension and diabetes mellitus.

  6. [Relevance of diabetes in high cardiovascular risk hypertensive patients].

    Science.gov (United States)

    Segura, Julián; de la Sierra, Alejandro; Fernández, Sandra; Ruilope, Luis M

    2013-10-05

    The aim of this cross-sectional study was to compare the prevalence of target organ damage (TOD) and established cardiovascular disease (CVD) in a cohort of nondiabetic hypertensive patients with 3 or more cardiovascular risk factors (CVRF) against a group of hypertensives with type 2 diabetes. We included 4,725 hypertensive patients, 62% male, mean age 64 (SD 12) years, with type 2 diabetes mellitus, independently of the number of associated CVRF (N=2,608), or non-diabetics, in which case we required the presence of 3 CVRF (N=2,117). The prevalence of established CVD (clinical interview) and TOD (left ventricular hypertrophy by electrocardiogram, microalbuminuria and estimated glomerular filtration rate) were estimated. Hypertensive patients with type 2 diabetes had an older age and more marked obesity. Furthermore, these patients showed a higher prevalence of micro- and macroalbuminuria, renal failure, left ventricular hypertrophy, atherosclerotic plaques in carotid arteries and CVD compared with nondiabetic hypertensive patients with 3 or more CVRF. Multivariate analysis showed that the risk of TOD or established CVD were associated independently with the presence of diabetes. Hypertensive patients with type 2 diabetes have a higher prevalence of LOD and CVD compared to nondiabetic hypertensive patients with 3 or more CVRF. Although both situations are included in the high cardiovascular risk stratum, it would be expected an increased incidence of cardiovascular complications in hypertensive diabetic patients. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories.

    Science.gov (United States)

    Tsimihodimos, Vasilis; Gonzalez-Villalpando, Clicerio; Meigs, James B; Ferrannini, Ele

    2018-03-01

    Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitus is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during the development of hypertension in patients with or without diabetes mellitus using data from the MCDS (Mexico City Diabetes Study; a population-based study of diabetes mellitus in Hispanic whites) and in the FOS (Framingham Offspring Study, a community-based study in non-Hispanic whites) during a 7-year follow-up. Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS, odds ratio, 3.14; 95% confidence interval, 2.17-4.54) independently of sex, age, body mass index, and familial diabetes mellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus (in FOS, odds ratio, 3.33; 95% CI, 2.50-4.44). In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mm Hg for systolic BP within 3.5 years (in MCDS). In comparison with the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall, results were similar in the 2 ethnic groups. We conclude that (1) development of hypertension and diabetes mellitus track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent of progression to 2 respective disease states. © 2018 American Heart Association, Inc.

  8. Vascular responsiveness in isolated perfused kidneys of diabetic hypertensive rats

    NARCIS (Netherlands)

    Beenen, O. H.; Mathy, M. J.; Pfaffendorf, M.; van Zwieten, P. A.

    1996-01-01

    The aim of this study was to investigate whether diabetes and hypertension cause additive effects in the responses to various vasoconstrictor and vasodilator agents, in isolated perfused kidneys obtained from streptozotocin (STZ)-diabetic Wistar-Kyoto (WKY) rats and from diabetic spontaneously

  9. Diabetes and hypertension in urban bhutanese men and women

    Directory of Open Access Journals (Sweden)

    Bhakta Raj Giri

    2013-01-01

    Full Text Available Background: Bhutan is a mountainous country with 31% urban population. There is no information on prevalence of diabetes and hypertension in Bhutan yet. This was the first study of its kind conducted in the capital city. Objective: To determine prevalence of diabetes, impaired fasting glucose (IFG, impaired glucose tolerance (IGT and hypertension in urban Bhutanese population aged 25 to 74 years. Materials and Methods: Stratified two-stage sampling was adopted to include 2474 respondents (Males: 1132, Females: 1342 equally distributed among different age and sex groups. A questionnaire containing demographic, educational and social details and history of diabetes and hypertension was administered on the sampled population the previous evening and blood pressure measured the next morning in nearby camp where fasting blood samples were collected and an oral glucose tolerance test done. Results: Age and sex standardized prevalence of diabetes, IGT and IFG were 8.2.0, 21.6 and 4%, respectively. Only 66.5% of the population had normal blood sugar. Prevalence of diabetes and IGT increased progressively with increasing age. Prevalence of hypertension was 26% (Males: 28.3%, Females: 23.2%. It was observed that 54.1% of diabetes population had hypertension. Conclusion: The study shows that not only is prevalence of diabetes and hypertension high in the urban Bhutanese but also there is a high diagnosis and treatment gap in these disorders.

  10. Knowledge of diabetes and hypertension among members of ...

    African Journals Online (AJOL)

    communicable diseases (NCD) that contribute to a large number of adult morbidity and mortality. The objective of this study was to determine knowledge of diabetes and hypertension and the associated risk factors among members of teaching staff.

  11. Chronic Hypertension with Gestational Diabetes Mellitus: What About Complications?

    OpenAIRE

    A Campos; Massa, AC; Rangel, R.; Cardoso, M.; Borges, A

    2016-01-01

    The aim of this study was to evaluate the impact of chronic hypertension and gestational diabetes on pregnancy outcomes. We conducted a historical cohort study of 334 women undergoing singleton births in a Portuguese tertiary care center in Lisbon during 2012. Women were categorized into gestational diabetes mellitus with or without chronic hypertension. Pregnancy outcomes were compared using nonparametric tests. Multivariable analysis was used to control for potential confounders. The rate o...

  12. Diabetes and hypertension: experimental models for pharmacological studies

    NARCIS (Netherlands)

    van Zwieten, P. A.

    1999-01-01

    Since hypertensive and diabetes-mellitus frequently occur simultaneously there exists a requirement for animal models where both pathological entities are combined. The streptozotocin (STZ)-spontaneously hypertensive rat (STZ-SHR) and the obese Zucker rat are examples of animal models where

  13. Control of hypertension among diabetic patients in a referral hospital ...

    African Journals Online (AJOL)

    Background: Hypertension is common among diabetic patients. The co-existence of two conditions carries an excessive risk of severe complications and mortalities. Limited information exists on the determinants of poor hypertension control among these patients. We aimed at determining the prevalence and factors ...

  14. Incident diabetes, hypertension and dyslipidemia in a Manitoba First Nation

    Directory of Open Access Journals (Sweden)

    Natalie D. Riediger

    2015-08-01

    Full Text Available Background: Diabetes and diabetes complications are substantially higher among Canadian First Nations populations compared with the general Canadian population. However, incidence data using detailed individual assessments from a population-based cohort have not been undertaken. Objective: We sought to describe incident diabetes, hypertension and dyslipidemia in a population-based cohort from a Manitoba Ojibway First Nation community. Design: Study data were from 2 diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort comprised of respondents to both screening studies (n=171. Health and demographic data were collected using a questionnaire. Fasting blood samples, blood pressure and anthropometric data were also collected objectively. Incident diabetes, hypertension and dyslipidemia were determined. Generalized linear models with Poisson distribution were used to estimate risk of incident diabetes and cardiometabolic conditions according to age and sex. Results: There were 35 (95% CI: 26, 45 new cases of diabetes among 128 participants without diabetes at baseline (27 or 3.3% per year. While participants who were 50 years and older at baseline had a significantly higher risk of incident diabetes at follow-up compared with participants aged 18–29 at baseline (p=0.012, more than half of the incident cases of diabetes occurred among participants aged less than 40 at baseline. There were 28 (95% CI: 20, 37 new cases of dyslipidemia at follow-up among 112 without dyslipidemia at baseline (25%. There were 36 (95% CI: 31, 42 new cases of hypertension among 104 participants without hypertension at baseline (34.6%. Women had half the risk of developing hypertension compared with men (p=0.039. Conclusions: Diabetes incidence is very high, and the number of new cases among those younger than 40 is a concern. Additional public health and primary care efforts are needed to address the

  15. Prevalence of hypertension in type-2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    K Venugopal

    2014-01-01

    Full Text Available Aims and Objectives: 1 To study the prevalence of hypertension in Type-2 diabetic patients. 2 To study the association with hypertension and diabetic complications. Materials and Methods: A total of 250 diabetic patients coming to Vijayanagara Institute of Medical Sciences Hospital and College, Bellary were studied and evaluated for blood pressure (BP, and macrovascular and microvascular complication. Study Design: A cross-sectional study. Sample Size: 250. Inclusion Criteria: All Type-2 diabetic patients who are on treatment for diabetes. Exclusion Criteria: a. Newly diagnosed diabetes, b. Seriously ill patients, c. Refused to be a part of the study, d. Pregnancy, e. Type-1 diabetes mellitus. Results and Conclusion: Prevalence of hypertension noted in 64 (25.6% patients. BP was normal in 55 (22%, 131 (52.4% patients were prehypertensive, 45 (18% patients were in stage-1 hypertension, and 19 (7.6% had stage-2 hypertension. Macrovascular complications noted in 120 (48% and microvascular complications noted in 60 (24% patients.

  16. Intensiveret behandling at type 2-diabetes mellitus. Er polyfarmaci nødvendig og berettiget?

    DEFF Research Database (Denmark)

    Pedersen, O B; Gaede, P H

    2000-01-01

    Newly published randomised controlled trials with pharmacological intervention against hyperglycaemia, hypertension and dyslipidemia have challenged the traditional empiric treatment of type 2-diabetes. This review focuses on the results of these trials as well as randomised trials with pharmacol...

  17. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    Directory of Open Access Journals (Sweden)

    Alberto Francisco Rubio-Guerra

    2010-09-01

    Full Text Available Alberto Francisco Rubio-Guerra1, Hilda Vargas-Robles2, Luz Maria Ramos-Brizuela1, Bruno Alfonso Escalante-Acosta21Metabolic Clinic, Hospital General de Ticomán SS DF, Mexico; 2Department of Molecular Biomedicine, Centro de Investigacion y de Estudios Avanzados del IPN, MexicoAbstract: Nitric oxide (NO is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients.Keywords: tetrahydrobiopterin, endothelial dysfunction, diabetes, hypertension, oxidative stress, nitric oxide, eNOS synthase uncoupling

  18. Combating Combination of Hypertension and Diabetes in Different Rat Models

    Directory of Open Access Journals (Sweden)

    Talma Rosenthal

    2010-03-01

    Full Text Available Rat experimental models are used extensively for studying physiological mechanisms and treatments of hypertension and diabetes co-existence. Each one of these conditions is a major risk factor for cardiovascular disease (CVD, and the combination of the two conditions is a potent enhancer of CVD. Five major animal models that advanced our understanding of the mechanisms and therapeutic approaches in humans are discussed in this review: Zucker, Goto-Kakizaki, SHROB, SHR/NDmcr-cp and Cohen Rosenthal diabetic hypertensive (CRDH rats. The use of various drugs, such as angiotensin-converting enzyme (ACE inhibitors (ACEIs, various angiotensin receptor blockers (ARBs, and calcium channel blockers (CCBs, to combat the effects of concomitant pathologies on the combination of diabetes and hypertension, as well as the non-pharmacological approach are reviewed in detail for each rat model. Results from experiments on these models indicate that classical factors contributing to the pathology of hypertension and diabetes combination—Including hypertension, hyperglycemia, hyperinsulinemia and hyperlipidemia—can now be treated, although these treatments do not completely prevent renal complications. Animal studies have focused on several mechanisms involved in hypertension/diabetes that remain to be translated into clinical medicine, including hypoxia, oxidative stress, and advanced glycation. Several target molecules have been identified that need to be incorporated into a treatment modality. The challenge continues to be the identification and interpretation of the clinical evidence from the animal models and their application to human treatment.

  19. [Hypertension, microalbuminuria and insulin resistance in diabetes mellitus].

    Science.gov (United States)

    Bretzel, R G

    1994-01-01

    Patients with diabetes mellitus are more frequently hypertensive than age-matched non-diabetic subjects. They are confronted with a markedly increased risk of coronary vascular disease, of progressive nephropathy and renal end-stage diseases. The most common type of hypertension in type I and type II diabetics is essential hypertension, probably as a consequence of insulin resistance and hyperinsulinemia. Hyperglycemia and hypertension are both significantly involved in the progression of diabetic nephropathy. Hence, the modern therapeutic concept consists of optimal blood glucose control and strict blood pressure control. Progression of the nephropathy may be halted in most of the cases by adhering to set limits in mean arterial blood pressure, glycated hemoglobin and urinary albumin excretion rate. Furthermore, a significant decrease in cardiovascular mortality may be achieved. In case the blood pressure targets cannot be met by non-drug therapies and life-style modifications, antihypertensive drug therapy has to be initiated. The selection of antihypertensives should be based on the concomitant diabetes mellitus with its additional cardiovascular risk factors hyperlipidemia and hyperinsulinemia. In general, preference should be given to so-called metabolic neutral substances such as ACE inhibitors or calcium antagonists or to alpha-blockers which may have positive metabolic effects. Meanwhile, data from several prospective studies claim that ACE inhibitors and calcium antagonists exert nephroprotective effects beyond their beneficial blood pressure lowering effects, thereby preventing the progression of diabetic nephropathy. However, these drugs should not be uncritically used and we should be aware of their potential adverse effects. The differential therapy of hypertension in diabetes mellitus requires mature consideration before initiation of therapy, an individualized concept of therapy, and careful monitoring during treatment.

  20. Perceptions of hypertension treatment among patients with and without diabetes

    Directory of Open Access Journals (Sweden)

    Anthony Heymann

    2012-03-01

    Full Text Available Abstract Background Despite the availability of a wide selection of effective antihypertensive treatments and the existence of clear treatment guidelines, many patients with hypertension do not have controlled blood pressure. We conducted a qualitative study to explore beliefs and perceptions regarding hypertension and gain an understanding of barriers to treatment among patients with and without diabetes. Methods Ten focus groups were held for patients with hypertension in three age ranges, with and without diabetes. The topic guides for the groups were: What will determine your future health status? What do you understand by "raised blood pressure"? How should one go about treating raised blood pressure? Results People with hypertension tend to see hypertension not as a disease but as a risk factor for myocardial infarction or stroke. They do not view it as a continuous, degenerative process of damage to the vascular system, but rather as a binary risk process, within which you can either be a winner (not become ill or a loser. This makes non-adherence to treatment a gamble with a potential positive outcome. Patients with diabetes are more likely to accept hypertension as a chronic illness with minor impact on their routine, and less important than their diabetes. Most participants overestimated the effect of stress as a causative factor believing that a reduction in levels of stress is the most important treatment modality. Many believe they "know their bodies" and are able to control their blood pressure. Patients without diabetes were most likely to adopt a treatment which is a compromise between their physician's suggestions and their own understanding of hypertension. Conclusion Patient denial and non-adherence to hypertension treatment is a prevalent phenomenon reflecting a conscious choice made by the patient, based on his knowledge and perceptions regarding the medical condition and its treatment. There is a need to change perception

  1. Calcium antagonists and the diabetic hypertensive patient

    DEFF Research Database (Denmark)

    Parving, H H; Rossing, P

    1993-01-01

    reduces albuminuria, delays the progression of nephropathy, and postpones renal insufficiency in diabetic nephropathy. Calcium antagonists and angiotensin converting enzyme inhibitors induce an acute increase in the glomerular filtration rate, renal plasma flow, and renal sodium excretion...... nephropathy alone and is rapidly rising. Increased arterial blood pressure is an early and common finding in incipient and overt diabetic nephropathy. Fluid and sodium retention with normal concentrations of active renin, angiotensin I and II, and aldosterone has been demonstrated in diabetic renal disease...

  2. Role of Trace Elements In Diabetes And Hypertension | Odusan ...

    African Journals Online (AJOL)

    Nigerian Endocrine Practice ... Low concentrations and imbalances of certain trace elements occur from poor dietary intake, chronic illnesses,disasters or old age and may result in malfunction of the cardiovascular system, hypertension, arrhythmias andsudden death, or be significantly associated with diabetes. Major role of ...

  3. Clinical outcomes in hypertensive or diabetes patients who ...

    African Journals Online (AJOL)

    Background: The use of complementary medicines in addition to medical prescription by patients with hypertension, diabetes and other chronic diseases presents a challenge for healthcare providers in Nigeria and globally. There is very little data on the clinical outcomes in these patients. Objectives: To evaluate clinical ...

  4. Hypertension, obesity and central obesity in diabetics and non ...

    African Journals Online (AJOL)

    Diabetes mellitus coexists at a greater frequency with hypertension, obesity, central obesity, dyslipedemia and proteinuria and that markedly increases the risk of atherosclerotic disease. A study was done for a period of four months in Sidama Zone, Southern Ethiopia to compare the prevalence of atherosclerotic risk factors ...

  5. Hypertension and diabetes mellitus among adults at Ehime Mbano ...

    African Journals Online (AJOL)

    Objective: Diabetes mellitus and hypertension are common diseases that tend to coexist. and result to These two diseases can lead to damage of some organs in the body like the eyes, brain, heart and kidneys. A study was carried out at Ehime Mbano Local Government Area of Imo State in Nigeria to determine the ...

  6. The burden of hypertension and diabetes mellitus in rural ...

    African Journals Online (AJOL)

    Introduction: the African region of the world is experiencing a double epidemic of both communicable and non-communicable diseases. The objective of the study was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria. Methods: a community ...

  7. Co-Occurrence of Diabetes and Hypertension: Pattern and Factors ...

    African Journals Online (AJOL)

    Background : There is a high frequency of co-occurrence of diabetes and hypertension all over the world. Such association results in higher rate of cardiovascular complications. It is however not clear whether the order of occurrence distinguishes two different groups of patients and the implications of this on morbidity and ...

  8. Priapism with Diabetes and Hypertension – A Case Report ...

    African Journals Online (AJOL)

    Clinical case report of a 55 year old policeman with diabetes and systemic hypertension, who presented with acute priapism. There was no obvious precipitating factor except for a poorly controlled blood sugar level. He was managed as a case of hyperglycemic emergency with saline infusion and insulin therapy while the ...

  9. Medication management of hypertension and diabetes mellitus at ...

    African Journals Online (AJOL)

    Despite the call for timely diagnosis and management of hypertension (HTN) and diabetes mellitus (DM), recent developments in outcomes of their medication management in concerned patients remain largely unimpressive. This study is aimed at assessing the impact of pharmacist-led health educational intervention on ...

  10. Effect of lipo-abdominoplasty on diabetes mellitus and hypertension ...

    African Journals Online (AJOL)

    Patient: He was a 40 year old male patient with BMI of 42kg/m2 and history of steroid abuse, known diabetic and hypertensive. He suffered from ... Conclusion: Though “cosmetic surgery is contraindicated in patients with BMI of more than 35kg/m2 lipoabdominoplasty could be considered a therapeutic procedure. More work ...

  11. Perceptions of cardiovascular risk among patients with hypertension or diabetes.

    NARCIS (Netherlands)

    Frijling, B.D.; Lobo, C.M.; Keus, I.M.; Jenks, K.M.; Akkermans, R.P.; Hulscher, M.E.J.L.; Prins, A.; Wouden, J.C. van der; Grol, R.P.T.M.

    2004-01-01

    We aimed to examine risk perceptions among patients at moderate to high cardiovascular risk. A questionnaire about perceived absolute risk of myocardial infarction and stroke was sent to 2424 patients with hypertension or diabetes. Response rate was 86.3% and 1557 patients without atherosclerotic

  12. Knowledge of diabetes and hypertension among members of ...

    African Journals Online (AJOL)

    The objective of this study was to determine knowledge of diabetes and hypertension and the associated risk factors among members of teaching staff of Higher Learning Institutions in Dar es Salaam, Tanzania. A cross sectional community based study was conducted in 10 higher learning institutions including universities.

  13. Diabetes or Hypertension as Risk Indicators for Missing Teeth ...

    African Journals Online (AJOL)

    2018-02-07

    5 days ago ... Background: To determine an exploratory estimation of the strength of type 2 diabetes mellitus (T2DM) and hypertension diagnoses as risk indicators for missing teeth in a sample of Mexican adults. Materials and Methods: A comparative cross-sectional study of sixty adult patients in a health center in ...

  14. Hypertension with diabetes mellitus: significance from an epidemiological perspective for Japanese.

    Science.gov (United States)

    Tatsumi, Yukako; Ohkubo, Takayoshi

    2017-09-01

    The prevalence of both hypertension and diabetes mellitus is increasing worldwide. Both diseases lead to severe complications such as cardiovascular and chronic kidney diseases, which increase the risk of death over a long period of time. Therefore, the prevention and aggravation of hypertension and diabetes mellitus are major challenges. Because few review articles have focused on the epidemiological perspective of hypertension and diabetes mellitus, we reviewed major observational studies mainly from Japan and from Western countries that have reported on the prevalence of hypertension and diabetes mellitus, the binominal risk of hypertension and diabetes mellitus, and the risk of their coexistence. Our investigation found that approximately 50% of diabetic patients had hypertension, and approximately 20% of hypertensive patients had diabetes mellitus. Those with either hypertension or diabetes mellitus had a 1.5- to 2.0-fold higher risk of having both conditions. These results were similar for both Japan and Western countries. Although comparing the results between Japan and Western countries was difficult because the risks were estimated using widely varying statistical analyses, it was revealed that the coexistence of hypertension and diabetes mellitus certainly increased the risk of complications regardless of the country. The definition, prevalence and medical treatment of hypertension and diabetes mellitus will change in the future. For early intervention based on the latest evidence to prevent severe complications, it is important to accumulate epidemiological knowledge of hypertension and diabetes mellitus and to update the evidence for both Japan and other countries.

  15. Increased sympathetic activity during sleep and nocturnal hypertension in Type 2 diabetic patients with diabetic nephropathy

    DEFF Research Database (Denmark)

    Nielsen, F S; Hansen, H P; Jacobsen, P

    1999-01-01

    (plasma noradrenaline and adrenaline) and the internal 'body clock' (serum melatonin) were investigated in 31 hypertensive Type 2 diabetes mellitus (DM) patients with diabetic nephropathy (24 males, age 60 (45-73) years). All variables, except extracellular volume, were measured repeatedly...

  16. Prevalence of pre-diabetes, diabetes, pre-hypertension, and hypertension in children weighing more than normal

    Directory of Open Access Journals (Sweden)

    Priti Phatale

    2012-01-01

    Full Text Available Aim: Prevalence of pre-diabetes, diabetes, pre-hypertension (pre-HT, and hypertension (HT in children weighing more than normal. Materials and Methods: Three- to eighteen-year old children weighing more than normal were included. Pathological short children were excluded. According to Centre for Disease Control (CDC, children are grouped into overweight (OW and obese (OB. Indian B.P. reference tables are used for defining HT and pre-HT. [2] HbA1c by HPLC (BIO RAD method was used to define pre-diabetes and diabetes. [3] Children with HbA1c ≥6.5 were subjected for Glucose Tolerance Test (GTT. C-peptide assay was done to rule out (r/o IDDM. Observations: When we compare this with our earlier presentation at PEDICON 2011, we found that hypertension (HTN (22.9% vs. 23.07% is not significantly different but pre-HTN (28.09% vs. 33.9%, pre-diabetes mellitus (pre-DM (3.7% vs. 64.3%, and diabetes mellitus (DM (0.35% vs. 3.8% are significantly high in this study. Conclusion: (1 Prevalence of HT (22.90% vs. 23.07% is similar in both groups but pre-HT (33.9% vs. 28.09% is high in this study. (2 Significant rise in prevalence of diabetes (3.84% vs. 0.35% and pre-diabetes (64.33% vs. 3.7% is seen in this study. (3 This change is because of using HbA1c as screening tool in children weighing more than normal.

  17. The effects of diabetes mellitus and hypertension on work productivity.

    Science.gov (United States)

    Krstović-Spremo, Vesna; Račić, Maja; Joksimović, Bojan N; Joksimović, Vedrana R

    2014-01-01

    The primary objective of this paper is to examine the impact of diabetes mellitus on the ability to work in patients with diabetes mellitus. The second objective of this paper is to examine the differences in the ability to work between patients with diabetes mellitus and patients with other chronic diseases, such as hypertension. A study was conducted in 10 family medicine practices from two primary health care centers, Pale and East Sarajevo, in the period between July 2009 and May 2010, utilising a retrospective medical records review and a cross sectional survey. The outcomes used to portray respondent's health status included functional measures and ability to work. Functional measures were analyzed using SF-36 and a general questionnaire. Absenteeism and productivity loss were retrospectively analyzed for the past ten years from a regional sick-leave database and the administrative records of the Commission for the assessment of work capacity for the Pension and Disability Insurance Fund of the Republika Srpska respectively. Out of the total number of patients with diabetes, 24.6% had some form of disability. A statistically significant difference was found between the two groups; patients with diabetes mellitus were much more likely to have problems meeting the required standards at the workplace due to emotional and physical health issues compared to hypertensive patients. Diabetes mellitus appears to reduce an individual's ability to work in comparison to patients with hypertension. There is a need to set up a diabetes mellitus prevention program and to develop and implement effective targeted intervention to help workers to manage their disease better. Copyright © 2014 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  18. Diabetes screening: a pending issue in hypertense/obese patients

    Directory of Open Access Journals (Sweden)

    Armina Sepehri

    2015-04-01

    Full Text Available The literature about possible cardiovascular consequences of diagnostic inertia in diabetes is scarce. We examined the influence of undetected high fasting blood glucose (FBG levels on the cardiovascular risk and poor control of cardiovascular risk factors in hypertensive or obese patients, with no previous diagnosis of diabetes mellitus (i.e., diagnostic inertia. A cross-sectional study during a preventive program in a Spanish region was performed in 2003–2004. The participants were aged ≥40 years and did not have diabetes but were hypertensive (n = 5, 347 or obese (n = 7, 833. The outcomes were high cardiovascular risk (SCORE ≥5%, poor control of the blood pressure (≥140/90 mmHg and class II obesity. The relationship was examined between FBG and the main parameters, calculating the adjusted odd ratios with multivariate models. Higher values of FBG were associated with all the outcomes. A more proactive attitude towards the diagnosis of diabetes mellitus in the hypertensive and obese population should be adopted.

  19. The Comorbidities of Diabetes and Hypertension: Mechanisms and Approach to Target Organ Protection

    OpenAIRE

    Long, Amanda N.; Dagogo-Jack, Samuel

    2011-01-01

    Up to 75% of adults with diabetes also have hypertension, and patients with hypertension alone often show evidence of insulin resistance. Thus, hypertension and diabetes are common, intertwined conditions that share a significant overlap in underlying risk factors (including ethnicity, familial, dyslipidemia, and lifestyle determinants) and complications. These complications include microvascular and macrovascular disorders. The macrovascular complications, which are well recognized in patien...

  20. CO-OCCURRENCE OF DIABETES AND HYPERTENSION ...

    African Journals Online (AJOL)

    people with diabetes than in the general population.1-3. Both diseases .... with mean age of 61.1 (SD 11.1) years. The median .... in their age, gender distribution, BMI, hip/waist ratio, ... example, in the US population, Movahed and co- workers ...

  1. Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus

    NARCIS (Netherlands)

    Heida, Karst Y.; Franx, Arie; van Rijn, Bas B.; Eijkemans, Marinus J. C.; Boer, Jolanda M. A.; Verschuren, Monique W. M.; Oudijk, Martijn A.; Bots, Michiel L.; van der Schouw, Yvonne T.

    2015-01-01

    A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of

  2. Hypertension and Diabetes Mellitus Program evaluation on user's view.

    Science.gov (United States)

    da Silva, Juliana Veiga Mottin; Mantovani, Maria de Fátima; Kalinke, Luciana Puchalski; Ulbrich, Elis Martins

    2015-01-01

    to evaluate the program proposed by the Reorganization Care Plan for Hypertension and Diabetes Mellitus on user's view, and describe aspects of the trajectory of the participants correlating with the program's evaluation. evaluative study with a qualitative approach conducted in health units with the Family Health Strategy, in a city of the metropolitan region of Curitiba, in the period from September to March, 2012. A total of 30 adults with hypertension and/or Diabetes mellitus were interviewed. Data were analyzed through content analysis. Four categories were identified: Disease diagnosis; Reasons for the program need; Knowledge of the program, and program evaluation. there was the recognition of the orientations, and the monitoring of activities developed, with emphasis in cost reduction for users.

  3. Diabetes or hypertension as risk indicators for missing teeth ...

    African Journals Online (AJOL)

    Diabetes or hypertension as risk indicators for missing teeth experience: An exploratory study in a sample of Mexican adults. V.J. Delgado-Pérez, R. De La Rosa-Santillana, M.L. Márquez-Corona, L. Ávila-Burgos, H. Islas-Granillo, M. Minaya-Sánchez, C.E. Medina-Solís, G. Maupomé ...

  4. Educational strategies for the prevention of diabetes, hypertension, and obesity

    Directory of Open Access Journals (Sweden)

    Alexandre Paulo Machado

    Full Text Available Summary Objective: The main goal of this work was to produce a review of educational strategies to prevent diabetes, hypertension, and obesity. Method: PubMed database was consulted using combined descriptors such as [Prevention], [Educational Activities], [Diabetes], [Hypertension], and [Obesity]. Data from randomized trials published between 2002 and 2014 were included in spreadsheets for analysis in duplicate by the reviewers. Results: A total of 8,908 articles were found, of which 1,539 were selected about diabetes mellitus (DM, n=369, arterial systemic hypertension (ASH, n=200, and obesity (OBES, n=970. The number of free full text articles available was 1,075 (DM = 276, ASH = 118 and OBES = 681. In most of these studies, demographic characteristics such as gender and age were randomized, and the population mainly composed by students, ethnic groups, family members, pregnant, health or education professionals, patients with chronic diseases (DM, ASH, OBES or other comorbidities. Group dynamics, physical activity practices, nutritional education, questionnaires, interviews, employment of new technologies, people training and workshops were the main intervention strategies used. Conclusion: The most efficient interventions occurred at community level, whenever the intervention was permanent or maintained for long periods, and relied on the continuous education of community health workers that had a constant interference inside the population covered. Many studies focused their actions in children and adolescents, especially on students, because they were more influenced by educational activities of prevention, and the knowledge acquired by them would spread more easily to their family and to society.

  5. Diabetes and Hypertension in Severe Obesity and Effects of Gastric Bypass-Induced Weight Loss

    Science.gov (United States)

    Sugerman, Harvey J.; Wolfe, Luke G.; Sica, Domenic A.; Clore, John N.

    2003-01-01

    Objective To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss. Summary Background Data Severe obesity is associated with multiple comorbidities, particularly hypertension and type 2 diabetes mellitus, that may affect life expectancy. Methods The database of patients who had undergone GBP by one general surgeon at a university hospital between September 1981 and January 2000 was queried as to weight, body mass index (BMI), pre- and postoperative diabetes, hypertension, and other comorbidities, including sleep apnea, hypoventilation, gastroesophageal reflux, degenerative joint disease, urinary incontinence, venous stasis, and pseudotumor cerebri. Results Of 1,025 patients treated, 15% had type 2 diabetes mellitus and 51% had hypertension. Of those with diabetes, 75% also had hypertension. There was a progressive increase in age between patients who had neither diabetes nor hypertension, either diabetes or hypertension, or both diabetes and hypertension. At 1 year after GBP (91% follow-up), patients lost 66 ± 18% excess weight (%EWL) or 35 ± 9% of their initial weight (%WL). Hypertension resolved in 69% and diabetes in 83%. Patients who resolved their hypertension or diabetes had greater %EWL and %WL than those who did not. African-American patients had a higher risk of hypertension than whites before GBP and were less likely to correct their hypertension after GBP. There was significant resolution of other obesity comorbidity problems. At 5 to 7 years after GBP (50% follow-up), %EWL was 59 ± 24 and %WL was 31 ± 13; resolution of hypertension was 66% and diabetes 86%. Conclusions These data suggest that type 2 diabetes mellitus and hypertension may be indirectly related to each other through the effects of obesity, but not directly as to cause and effect. The longer a person remains severely obese, the more likely he or she is to develop diabetes

  6. Magnesium metabolism in hypertension and type 2 diabetes mellitus.

    Science.gov (United States)

    Barbagallo, Mario; Dominguez, Ligia J; Resnick, Lawrence M

    2007-01-01

    The increasing evidence for the clinical relevance of altered magnesium metabolism to states of altered insulin resistance confirms the role of magnesium deficit as a possible underlying common mechanism of the "insulin resistance" of hypertension and altered glucose tolerance. The pioneer work of Lawrence M. Resnick and his group using the cellular ion-based approach that we are only partially presenting here has consistently contributed to the progress of the field, demonstrating (a) the critical importance of magnesium metabolism in regulating insulin sensitivity as well as vascular tone, and blood-pressure homeostasis; (b) that magnesium deficiency, defined on the basis of intracellular free magnesium levels, and or serum ionized magnesium is a common feature of both diabetic and hypertensive states as well as various other cardiovascular and metabolic processes and aging; (c) the ability of environmental factors such as dietary nutrient-sugar and mineral content to alter the set point of steady-state cell ion activity; and (d) that magnesium supplementation is indicated in conditions associated with magnesium deficit although well-designed therapeutic trials of magnesium in essential hypertension and type 2 diabetes mellitus are needed in the near future.

  7. Perception of uncontrolled blood pressure and non-adherence to anti-hypertensive agents in diabetic hypertensive patients.

    Science.gov (United States)

    Ledur, P S; Leiria, L F; Severo, M D; Silveira, D T; Massierer, D; Becker, A D; Aguiar, F M; Gus, M; Schaan, B D

    2013-01-01

    We assessed the association between adherence to antihypertensive drug treatment and patient's perception of uncontrolled blood pressure (BP) in diabetic hypertensive subjects. This was a cross-sectional study that evaluated adherence to antihypertensives (Morisky questionnaire), patients' perception of abnormal BP, office BP, and ambulatory BP monitoring in diabetic hypertensive subjects. We evaluated 323 patients, 65.2% women, aged 56.5 ± 7 years, glycosylated hemoglobin (HbA1c) 8.0% (range, 6.9%-9.6%), diabetes duration of 10 years (range, 5-17 years). Adherence to drug treatment was 51.4%. Patients who reported hypertension-related symptoms (60.4%) had a lower level of adherence (P hypertension-related symptoms (P anti-hypertensives, age, and duration of diabetes). Non-adherents had higher office diastolic BP (83.6 ± 11.9 vs. 79.8 ± 9.9; P = .003), but no difference between groups was observed considering systolic, diastolic, and mean BP evaluated by ambulatory BP monitoring. Low rates of adherence to antihypertensive drug treatment were observed in outpatient hypertensive diabetic subjects. Perception of uncontrolled BP levels was strongly and independently associated with non-adherence. Non-adherence determined repercussion on office BP that may have clinical implications in cardiovascular risk. Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  8. hypertension

    Directory of Open Access Journals (Sweden)

    Emine Hatipoglu

    2013-05-01

    Full Text Available Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.

  9. Hypertension and type 2 diabetes: A cross-sectional study in ...

    African Journals Online (AJOL)

    Background: In Morocco, there are no studies that focused on the hypertension and its associated risk factors through patients with type 2 diabetes. Different findings show that the frequency of type 2 diabetes has risen rapidly in Morocco. The main objective of this study was to assess the prevalence of hypertension and its ...

  10. Lipid profile of type 2 diabetic and hypertensive patients in the Jamaican population

    Directory of Open Access Journals (Sweden)

    Lorenzo Gordon

    2010-01-01

    Full Text Available Aims : Previous studies have shown that diabetes mellitus (DM increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods : The study included 107 type 2 diabetic patients (41 males and 66 females, and 122 hypertensive type 2 diabetic patients (39 males and 83 females, aged 15 years and older. Total cholesterol (TC, triglycerides (TG, low density lipoprotein-cholesterol (LDL-C, very low density lipoprotein-cholesterol (VLDL-C and high density lipoprotein-cholesterol (HDL-C concentrations were assayed for each group using standard biochemical methods. Results : The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05. Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L than hypertensive non-diabetic males (5.76±1.57 mmol/L; P 0.05. Conclusion : This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

  11. Prevalence of arterial hypertension in diabetic patients before and after the JNC-V

    DEFF Research Database (Denmark)

    Tarnow, L; Rossing, P; Gall, Mari-Anne

    1994-01-01

    OBJECTIVE: To compare the prevalence of arterial hypertension in patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) according to blood pressure (BP) criteria from the World Health Organization (WHO) and The Fifth Report of the Joint National...... had stage 2 (160-179/100-109 mmHg) hypertension. Two out of three untreated hypertensive patients had isolated systolic hypertension. CONCLUSIONS: The new JNC-V criteria approved by the American Diabetes Association leads to a considerable increase in the prevalence of arterial hypertension...... treatment were classified as hypertensives. RESULTS: In IDDM patients, the prevalence of arterial hypertension rose from 15 to 42% in the normoalbuminuric group, from 26 to 52% in the microalbuminuric group, and from 61 to 79% in the macroalbuminuric group when WHO and JNC-V criteria were compared...

  12. [Overweight, obesity, diabetes, and hypertension in endometrial cancer].

    Science.gov (United States)

    Sanz-Chávez, Tania L N; Vilar-Compte, Diana; de Nicola-Delfín, Luigina; Meneses-García, Abelardo

    2013-01-01

    in postmenopausal women, the excess of fat has been associated with an increased risk of endometrial cancer. The aim of the study was to determine the prevalence of overweight, obesity, diabetes and hypertension in patients with endometrial cancer. we collected demographic, clinical, laboratory and histopathological information from the electronic records of patients diagnosed with endometrial cancer in the period from January 2009 to July 2011. Subsequently descriptive analysis of the information was done. a total of 274 records. The average age of patients was 54 years. The 50.4 % were postmenopausal. At the time of diagnosis, 112 cases (48.6 %) were in clinical stage I. Of all patients, 104 (37.9 %) had diabetes mellitus, 122 (44.5 %) hypertension, 194 (72.6 %) were overweight or obese, and 24 cases were registered with the metabolic syndrome. in regards to this diagnosis the results show a higher incidence of overweight and obesity compared with other countries. It is necessary to conduct further studies to assess the relationship of excess fat as a risk factor for endometrial cancer.

  13. Hypertension, diabetes and overweight: looming legacies of the Biafran famine.

    Directory of Open Access Journals (Sweden)

    Martin Hult

    Full Text Available BACKGROUND: Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease, obesity, diabetes and hypertension. Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life. We undertook to study the risks for hypertension, glucose intolerance and overweight forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war (1967-1970. METHODS AND FINDINGS: Cohort study performed in June 27-July 31, 2009 in Enugu, Nigeria. Adults (n = 1,339 born before (1965-67, during (1968-January 1970, or after (1971-73 the years of famine were included. Blood pressure (BP, random plasma glucose (p-glucose and anthropometrics, as well as prevalence of hypertension (BP>140/90 mmHg, impaired glucose tolerance (IGT; p-glucose 7.8-11.0 mmol/l, diabetes (DM; p-glucose ≥11.1 mmol/l, or overweight (BMI>25 kg/m(2 were compared between the three groups. Fetal-infant exposure to famine was associated with elevated systolic (+7 mmHg; p<0.001 and diastolic (+5 mmHg; p<0.001 BP, increased p-glucose (+0.3 mmol/L; p<0.05 and waist circumference (+3 cm, p<0.001, increased risk of systolic hypertension (adjusted OR 2.87; 95% CI 1.90-4.34, IGT (OR 1.65; 95% CI 1.02-2.69 and overweight (OR 1.41; 95% CI 1.03-1.93 as compared to people born after the famine. Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine. CONCLUSIONS: Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians. Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health, education, and economic agendas.

  14. Effect of losartan on the blood-brain barrier permeability in diabetic hypertensive rats.

    Science.gov (United States)

    Kaya, M; Kalayci, R; Küçük, M; Arican, N; Elmas, I; Kudat, H; Korkut, F

    2003-11-07

    Our previous publication has stressed the benefits of losartan, an angiotensin II receptor blocker, on the permeability of blood-brain barrier (BBB) and blood pressure during L-NAME-induced hypertension. This study reports the impacts of anti-hypertensive treatment by losartan on the brain endothelial barrier function and the arterial blood pressure, during acute hypertension episode, in experimentally diabetic hypertensive rats. Systolic blood pressure measurements were taken with tail cuff method before and during administration of L-NAME (0.5 mg/ml). We induced diabetes by using alloxan (50 mg/kg, i.p). Losartan (3 mg/kg, i.v) was given to rats following the L-NAME treatment. Acute hypertensive vascular injury was induced by epinephrine (40 microg/kg). The BBB disruption was quantified according to the extravasation of the Evans blue (EB) dye. L-NAME induced a significant increase in arterial blood pressure on day 14 in normoglycemic and hyperglycemic rats (p hypertensive and diabetic hypertensive rats (p hypertension in diabetic hypertensive rats increased the content of EB dye dramatically in cerebellum and diencephalon (p cerebral cortex (p hypertensive rats treated with epinephrine (p hypertensive rats, epinephrine administration leads to an increase in microvascular-EB-albumin efflux to brain, however losartan treatment significantly attenuates this protein's transport to brain tissue.

  15. Diabetes, hypertension, obesity, and long-term risk of renal disease mortality: Racial and socioeconomic differences.

    Science.gov (United States)

    Moghani Lankarani, Maryam; Assari, Shervin

    2017-07-01

    Diabetes, hypertension, and obesity increase the risk of chronic kidney disease and associated mortality. Race and socioeconomic status (SES) differences in the effects of these risk factors are, however, still unknown. The current study aimed to investigate whether or not race and SES alter the effects of diabetes, hypertension, and obesity on mortality due to renal disease. Data came from the Americans' Changing Lives Study, 1986-2011, a nationally representative prospective cohort of adults with 25 years of follow up. The study included 3,361 adults aged 25 years and older who were followed for up to 25 years. The outcome was death from renal disease. Diabetes, hypertension, and obesity were the main predictors. Race and SES (education, income, and employment) were moderators. Health behaviors and health status at baseline were covariates. We used Cox proportional hazards models for data analysis. In separate models, diabetes, hypertension, and obesity at baseline were associated with a higher risk of death from renal disease. From our SES indicators, education and income interacted with diabetes, hypertension, and obesity on death from renal disease. In a consistent pattern, diabetes, hypertension, and obesity showed stronger effects on the risk of death from renal disease among high-SES groups compared with low-SES individuals. Race and employment did not alter the effects of diabetes, hypertension and obesity on the risk of death from renal disease. Social groups differ in how diabetes, hypertension, and obesity influence health outcomes over long-term periods. Elimination of disparities in renal disease mortality in the USA requires understanding of the complex and non-linear effects of socioeconomic and medical risk factors on health outcomes. Multidisciplinary programs and policies are required to reduce social inequality in renal disease burden caused by diabetes, hypertension, and obesity. © 2017 The Authors. Journal of Diabetes Investigation published

  16. Hypertensive diabetic patients: guidelines for conduct and their difficulties

    Directory of Open Access Journals (Sweden)

    Weimar K. S. Barroso

    2003-08-01

    Full Text Available OBJECTIVE: To assess the effect of blood pressure (BP control and other cardiovascular risk factors in patients with diabetes mellitus in a referral service for the treatment of hypertension. METHODS: A retrospective study where diabetic patients (at least 2 fasting glucose levels above 126 mg/dL, use of hypoglycemic agents or insulin, or both of these were included. They were evaluated at the first appointment (M1 and at the last appointment (M2, regarding blood pressure, body mass index (BMI, use of hypertensive drugs, glycemia, total cholesterol (TC, creatinine, and potassium. RESULTS: Of 1,032 patients studied, 146 patients with a mean age of 61.6 years had diabetes, and 27 were men (18.5%. Mean follow-up was 5.5 years. BP values were 161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In M1, 10.4% of the patients did not use medications, 50.6% used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or more drugs. In M2, these values were 10.9%, 39%, 39.7%, and 10.4%, respectively. Diuretics were the most commonly used medication, whereas angiotensin-converting enzyme inhibitors (ACE inhibitors were those drugs which presented greater increase when comparing M1 to M2 (24.6% and 41.7%, respectively. Only 17,1% reached the recommended goal (BP<130x85 mmhg. The other cardiovascular risk factors did not change significantly. CONCLUSION: Our data reinforce the necessity of a more aggressive approach in the treatment of these patients, despite the social and economic difficulties in adhering to treatment.

  17. CONTROL OF HYPERTENSION AFTER ROUX-EN-Y GASTRIC BYPASS AMONG OBESE DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Everton CAZZO

    2014-03-01

    Full Text Available Context Hypertension is a common disorder in general practice and has a widely known association with type 2 diabetes mellitus. Low adhesion to clinical treatment may lead to poor results. Obesity surgery can bring early and relevant resolution rates of both morbidities. Objective To describe hypertension evolution after Roux-en-Y gastric bypass in patients with type 2 diabetes mellitus. Method Descriptive observational study designed as a historical cohort of 90 subjects with hypertension and diabetes who underwent Roux-en-Y gastric bypass and were evaluated before and after surgery. Results It was observed a hypertension resolution rate of 85.6% along with markedly decrease in anti-hypertensive usage. Mean resolution time was 3.2 months. Resolution was associated with homeostasis model assessment – insulin resistance, preoperative fasting insulin, anti-hypertensive usage, hypertension time, body mass index and percentage of weight loss. Resolution of hypertension was not statistically associated with diabetes remission within this sample. Conclusion Roux-en-Y gastric bypass was a safe and effective therapeutic tool to achieve hypertension resolution in patients who also had diabetes mellitus.

  18. Prevalence of hypertension in type 1 (insulin-dependent) diabetes mellitus

    DEFF Research Database (Denmark)

    Nørgaard, K; Feldt-Rasmussen, B; Borch-Johnsen, K

    1990-01-01

    The prevalence of hypertension in a representative sample (n = 10202) of the Danish general population aged 16-59 years was assessed to 4.4% based on three blood pressure readings. In Type 1 (insulin-dependent) diabetic patients of similar age (n = 1703) the prevalence was determined in a similar...... way to 14.7% (p less than 0.00001). The excess prevalence in Type 1 diabetic patients was due to hypertension in patients with incipient and clinical nephropathy as the prevalence of hypertension among diabetic patients with normal urinary albumin excretion (essential hypertension) was 3.9%, similar...... to that observed in the general population. The patients with Type 1 diabetes and essential hypertension had higher systolic (146 +/- 19 vs 133 +/- 18 mm Hg, p less than 0.00001) and diastolic blood pressure (87 +/- 12 vs 79 +/- 7 mm Hg, p less than 0.00001), but less changes in the eye background than patients...

  19. Management of hypertension and diabetes mellitus by cardiovascular and endocrine physicians: a China registry.

    Science.gov (United States)

    Song, Jie; Sheng, Chang-Sheng; Huang, Qi-Fang; Li, Li-Hua; Ma, Chang-Sheng; Guo, Xiao-Hui; Ji, Li-Nong; Wang, Ji-Guang

    2016-08-01

    We investigated hypertension and diabetes mellitus in two management settings, namely cardiology and endocrinology, and their associations with albuminuria while accounting for the management of these two diseases. Our multicentre registry included patients (≥20 years) seen for hypertension in cardiology or for diabetes mellitus in endocrinology. We administered a questionnaire and measured blood pressure, glycosylated haemoglobin A1c and albuminuria. Presence of both hypertension and diabetes was observed in 32.9% of hypertensive patients in cardiology (n = 1291) and 58.9% of diabetic patients in endocrinology (n = 1168). When both diseases were present, the use of combination antihypertensive therapy [odds ratio (OR) 0.31, P hypertension and diabetes, however, was not different between the two management settings (P ≥ 0.21), regardless of the therapeutic target (SBP/DBP hypertension (12.6%) or diabetes alone (15.9%). Hypertension and diabetes mellitus were often jointly present, especially in the setting of endocrinology. The management was insufficient on the use of combination antihypertensive therapy and inhibitors of the renin-angiotensin system in endocrinology and for combination antidiabetic therapy in cardiology, indicating a need for more intensive management and better control of both clinical conditions.

  20. Body Mass Index or Microalbuminuria, Which One is More Important for the Prediction and Prevention of Diastolic Dysfunction in Non-diabetic Hypertensive Patients?

    National Research Council Canada - National Science Library

    Shemirani, Hasan; Khosravi, Alireza; Hemmati, Rohola; Gharipour, Mojgan

    2012-01-01

    ... dysfunction in non-diabetic hypertensive patients?' The current study was a cross-section study conducted on a total of 126 non-diabetic hypertensive patients screened to identify those with hypertension...

  1. Diabetes mellitus, hypertension and albuminuria in rural Zambia

    DEFF Research Database (Denmark)

    Rasmussen, Jon B; Thomsen, Jakúp A; Rossing, Peter

    2013-01-01

    OBJECTIVE: To assess albuminuria in rural Zambia among patients with diabetes mellitus only (DM group), hypertension only (HTN group) and patients with combined DM and HTN (DM/HTN group). METHODS: A cross-sectional survey was conducted at St. Francis Hospital in the Eastern province of Zambia....... Albumin-creatinine ratio in one urine sample was used to assess albuminuria. Other information obtained included age, sex, body mass index (BMI), waist circumference (WC), blood pressure (BP), glycosylated haemoglobin (HbA1c ), random capillary glucose, time since diagnosis, medication and family history.......0006) differed between the three groups. CONCLUSION: This hospital-based survey in rural Zambia found a lower frequency of albuminuria among the participants than in previous studies of patients with DM or HTN in urban sub-Saharan Africa....

  2. Nicardipine may impair glucose metabolism in hypertensive diabetic patients.

    Science.gov (United States)

    Sasaki, H; Naka, K; Kishi, Y; Ohoshi, T; Hagihara, T; Matsuo, H; Sowa, R; Matsumoto, G; Sanke, T; Nanjo, K

    1994-11-01

    The respective effects of 6 month's administration of beta-blockers (atenolol, metoprolol, carteolol and arotinolol), calcium-channel blockers (nicardipine, diltiazem) and angiotensin converting enzyme inhibitor (enalapril) on hemoglobin A1c (HbA1c) levels were evaluated in hypertensive patients with non-insulin-dependent diabetes mellitus (NIDDM), using a retrospective method. NIDDM patients with stable HbA1c and body weight were selected for this study. The following results were obtained. (1) The administration of nicardipine or beta-blockers significantly elevated HbA1c levels. (2) The administration of diltiazem or enalapril did not have any influence on HbA1c levels. These findings suggest that not only beta-blocker but nicardipine (dihydropyridine type calcium-channel blocker) may cause deterioration in glucose metabolism in NIDDM patients.

  3. Management of the unholy trinity diabetes-obesity-hypertension (diabesotension).

    Science.gov (United States)

    Sharabi, Yehonatan

    2012-11-20

    Diabetes, obesity and hypertension are common conditions and their concurrence is more common than would have been expected: 15% of the developed world suffer from the triad of "diabesotension". The pathophysiology involves characteristic neurohormonal profiles that collectively suggest the consideration of diabesotension as a distinct clinical entity. Diabesotensive patients have double the risk of suffering from the micro and macrovascular complications of each of the conditions alone. Therefore, it is critical to reduce their overall risk and provide them with special attention. Studies have shown that the number needed to treat in diabesotension is lower compared to non-obese. Appropriate treatment goals should be set. With regards to hypertension, recent clinical trials point to 130-135/80-85 mmHg. Lifestyle modifications are critical, therefore DASH and Mediterranean diet should be recommended along with a physical training program. Weight reduction strategies often fail and bariatric surgery should be considered. All antihypertensive drug-classes are adequate to treat uncomplicated diabesotension and it is not mandatory to include RAAS blockers as first-line therapy. However, as second line, for high risk patients and patients with nephropathy - a RAAS blocker is indicated. Combination therapy is almost always prescribed in the course of the disease. In the absence of compelling indications, a RAAS blocker with a calcium-channels blocker is preferred as it provides benefits beyond blood pressure control. Resistant hypertension is common, and secondary causes should be looked for, particularly sleep apnea. A novel procedure such as renal denervation is a promising option due to its antihypertensive and metabolic benefits. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Targeting nocturnal hypertension in type 2 diabetes mellitus.

    Science.gov (United States)

    Rossen, Niklas Blach; Knudsen, Søren Tang; Fleischer, Jesper; Hvas, Anne-Mette; Ebbehøj, Eva; Poulsen, Per Løgstrup; Hansen, Klavs Würgler

    2014-11-01

    Several studies in different populations have suggested that nighttime blood pressure (BP) is a stronger predictor of cardiovascular events than daytime BP. Consequently, treatment strategies to target nighttime BP have come into focus. The aim of the present study was to investigate the effect of change of administration time of antihypertensive drugs. We included 41 patients with type 2 diabetes mellitus and nocturnal hypertension (nighttime systolic BP >120 mm Hg) in an open-label, crossover study. Patients were randomized to 8 weeks of either morning or bedtime administration of all of the individual's once-daily antihypertensive drugs, followed by 8 weeks of switched dosing regimen. Bedtime administration of antihypertensive drugs resulted in a significant reduction in nighttime (7.5 mm Hg; Pdiabetes mellitus and nocturnal hypertension, administration of once-daily antihypertensive drugs at bedtime may be favorable. The increased nocturnal natriuresis may reflect increased effect of bedtime-administered thiazides and renin-angiotensin system inhibitors, suggesting a potential mechanism of the observed effects on BP with chronotherapeutic intervention. © 2014 American Heart Association, Inc.

  5. Increased plasma soluble endoglin levels as an indicator of cardiovascular alterations in hypertensive and diabetic patients

    Directory of Open Access Journals (Sweden)

    Martínez-Salgado Carlos

    2010-12-01

    Full Text Available Abstract Background Endoglin is involved in the regulation of endothelial function, but there are no studies concerning its relation with hypertension- and diabetes-associated pathologies. Thus, we studied the relationship between plasma levels of soluble endoglin and cardiovascular alterations associated with hypertension and diabetes. Methods We analyzed 288 patients: 64 with type 2 diabetes, 159 with hypertension and 65 healthy patients. We assessed the relationship of soluble endoglin plasma levels measured by enzyme-linked immunosorbent assay with basal glycemia, glycosylated hemoglobin, blood pressure, endothelial dysfunction (assessed by pressure wave velocity, hypertensive retinopathy (by Keith-Wagener classification, left ventricular hypertrophy (by Cornell and Sokolow indexes, cardiovascular risk and target organ (heart, vascular, kidney damage. Results There are significant correlations between endoglin and glycemia, systolic blood pressure, pulse pressure, pressure wave velocity and electrocardiographically assessed left ventricular hypertrophy. Endoglin levels were significantly higher in patients with diabetes who had nondipper and extreme dipper circadian blood pressure patterns than in dipper circadian patterns, in patients with hypertension and diabetes who had riser pattern than in the other patients, and in patients with diabetes but not hypertension who had extreme dipper pattern than in dipper, nondipper and riser groups. There was also a significant correlation between plasma-soluble endoglin and lower levels of systolic night-day ratio. Higher endoglin levels were found in patients with diabetes who had retinopathy, in patients with diabetes who had a high probability of 10-year cardiovascular risk, and in patients with diabetes and hypertension who had three or more damaged target organs (heart, vessels, kidney than in those with no organs affected. Conclusions This study shows that endoglin is an indicator of

  6. Diabetes and Hypertension among Patients Receiving Antiretroviral Treatment Since 1998 in Senegal: Prevalence and Associated Factors

    Science.gov (United States)

    Diouf, Assane; Cournil, Amandine; Ba-Fall, Khadidiatou; Ngom-Guèye, Ndèye Fatou; Eymard-Duvernay, Sabrina; Ndiaye, Ibrahima; Batista, Gilbert; Guèye, Papa Mandoumbé; Bâ, Pape Samba; Taverne, Bernard; Delaporte, Eric; Sow, Papa Salif

    2012-01-01

    Cardiovascular risk factors in people on antiretroviral treatment (ART) are poorly documented in resource-constrained settings. A cross-sectional study was conducted in 2009 to assess prevalence of diabetes and hypertension in a sample of 242 HIV-infected patients who had initiated ART between 1998 and 2002 in Dakar, Senegal (ANRS 1215 observational cohort). World Health Organization (WHO) criteria were applied to diagnose diabetes and hypertension. Multiple logistic regressions were used to identify factors associated with diabetes and hypertension. Patients had a median age of 46 years and had received ART for a median duration of about 9 years. 14.5% had diabetes and 28.1% had hypertension. Long duration of ART (≥119 months), older age, higher body mass index (BMI), and higher levels of total cholesterol were associated with higher risks of diabetes. Older age, higher BMI at ART initiation, and higher levels of triglycerides were associated with higher risk of hypertension. This study shows that diabetes and hypertension were frequent in these Senegalese HIV patients on ART. It confirms the association between duration of ART and diabetes and highlights the need to implement programs for prevention of cardiovascular risk factors in HIV patients from resource-constrained settings. PMID:24052880

  7. Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Langhoff-Roos, Jens; Sibai, Baha M

    2009-01-01

    for the development of type 2 diabetes mellitus. The end points were subsequent hypertension, ischemic heart disease, congestive heart failure, thromboembolic event, stroke, and type 2 diabetes mellitus. The risk of subsequent hypertension was increased 5.31-fold (range: 4.90 to 5.75) after gestational hypertension......Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first...... singleton (n=782 287) and 2 first consecutive singleton deliveries (n=536 419). The exposures were gestational hypertension and mild and severe preeclampsia. We adjusted for preterm delivery, small for gestational age, placental abruption, and stillbirth and, in a second model, we also adjusted...

  8. Nature of elevated blood pressure in normoalbuminuric type I diabetic patients. Essential hypertension?

    DEFF Research Database (Denmark)

    Nørgaard, K; Rasmussen, E; Jensen, T

    1993-01-01

    This study was undertaken to characterize type I diabetic patients with essential hypertension with respect to kidney function, renal hormones, and endothelial function. After 4 weeks without antihypertensive treatment, a cross-sectional study was carried out in the following groups: group 1, 14...... healthy controls; group 2, 13 nondiabetic patients with essential hypertension (blood pressure > or = 140/90 mm Hg); group 3, 11 type I diabetic patients with hypertension but urinary albumin excretion (UAE) persistently normal (UAE: 10 mg/24 h, range 3 to 18) both before, during, and after discontinuing...... antihypertensive treatment; group 4, 15 type I diabetic patients with clinical nephropathy (UAE: 611 mg/24 h, range 192 to 3837) and hypertension. Systolic and diastolic blood pressures were similar in the three hypertensive groups: 147/96 +/- 8/6, 150/94 +/- 11/9, and 152/92 +/- 12/6 mm Hg (groups 2, 3, and 4...

  9. White coat hypertension in NIDDM patients with and without incipient and overt diabetic nephropathy

    DEFF Research Database (Denmark)

    Nielsen, F S; Gaede, P; Vedel, P

    1997-01-01

    in normoalbuminuric NIDDM patients resembles that observed in nondiabetic subjects with essential hypertension, whereas the prevalence is significantly lower in NIDDM patients with incipient or overt diabetic nephropathy, suggesting a difference between primary and secondary hypertension.......OBJECTIVE: Early data have suggested a high prevalence of white coat hypertension (approximately 50%) in NIDDM patients. To study this phenomenon further, we determined the prevalence of white coat hypertension in NIDDM patients with normo- or microalbuminuria or with diabetic nephropathy. RESEARCH...... DESIGN AND METHODS: Three groups of hypertensive NIDDM patients (repeated clinic blood pressure > 140/90 mmHg or antihypertensive treatment) attending the Steno Diabetes Center were investigated in a cross-sectional study. Group 1 had normoalbuminuria (a urinary albumin excretion [UAE] rate

  10. [Blood pressure control in a population of hypertensive diabetic patients treated in primary care: PRESCAP-Diabetes Study 2010].

    Science.gov (United States)

    Barquilla García, A; Llisterri Caro, J L; Prieto Díaz, M A; Alonso Moreno, F J; García Matarín, L; Galgo Nafría, A; Mediavilla Bravo, J J

    2015-01-01

    To determine the level of blood pressure (BP) control in hypertensive diabetic patients treated in primary care and to determine the factors associated with poor control. A cross-sectional, multicentre study that enrolled hypertensive diabetics recruited by consecutive sampling by family doctors in Spain in June 2010. A mean BP of less than 140/90mmHg was considered as good control of arterial hypertension. The percentages of patients withPrimaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. Medical and Psychological Risk Factors for Incident Hypertension in Type 1 Diabetic African-Americans

    Directory of Open Access Journals (Sweden)

    Monique S. Roy

    2011-01-01

    Conclusions. The development of hypertension in African-Americans living with type 1 diabetes appears to be multifactorial and includes both medical (overt proteinuria as well as psychological (high hostility risk factors.

  12. Kidney Measures with Diabetes and Hypertension on Cardiovascular Disease : The Atherosclerosis Risk in Communities Study

    NARCIS (Netherlands)

    Alexander, Nadine; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana; Mahmoodi, Bakhtawar K.; Astor, Brad C.; Coresh, Josef

    2015-01-01

    Background: Whether the association of chronic kidney disease (CKD) with cardiovascular risk differs based on diabetes mellitus (DM) and hypertension (HTN) status remains unanswered. Methods: We investigated 11,050 participants from the Atherosclerosis Risk in Communities Study (fourth examination

  13. Dual blockade with candesartan cilexetil and lisinopril in hypertensive patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Andersen, Niels H; Knudsen, Søren T; Poulsen, Per L

    2003-01-01

    BACKGROUND: Blood pressure (BP) reduction is the key to risk reduction of cardiovascular disease or renal failure in hypertensive patients with diabetes mellitus. Inhibition of the renin-angiotensin system by an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker...... (ARB) provides efficient BP reduction and renal protection in hypertensive diabetes patients. But, despite this, the recommended BP levels can be difficult to achieve and dual blockade therapy might be a possible way of obtaining efficient BP reduction in hypertensive patients with diabetes. Dual......, active-controlled, parallel-group study, investigating the efficacy and tolerability of candesartan cilexetil in combination with lisinopril, compared with the maximum recommended dose of lisinopril in hypertensive patients with diabetes mellitus. The study design consists of two treatment arms...

  14. Novel risk factors in long-term hypertension incidence in type 1 diabetes mellitus.

    Science.gov (United States)

    Sahakyan, Karine; Klein, Barbara E K; Myers, Chelsea E; Tsai, Michael Y; Klein, Ronald

    2010-06-01

    Data from longitudinal studies suggest that biomarkers of inflammation and endothelial dysfunction are associated with development of hypertension. None of these studies have examined the association of these markers with hypertension risk in persons with diabetes. We examined the associations of inflammatory and endothelial dysfunction markers with long-term hypertension incidence in persons with type 1 diabetes mellitus. The 15-year cumulative incidence of hypertension was measured in Wisconsin Epidemiologic Study of Diabetic Retinopathy participants (n = 795). Hypertension was defined as a systolic blood pressure > or =140 mm Hg and/or a diastolic blood pressure > or =90 mm Hg and/or history of current antihypertensive treatment. We measured serum high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1, and serum total homocysteine as "novel" markers of hypertension development. The relation of risk factors to hypertension incidence was determined using a proportional hazards approach with discrete linear logistic regression modeling. After controlling for age, gender, diabetes duration, body mass index, glycosylated hemoglobin, baseline systolic and diastolic blood pressure, proteinuria, and chronic kidney disease status, sVCAM-1 was significantly related to higher odds of developing incident hypertension (odds ratio per log sVCAM-1 1.95, 95% CI 1.01-3.74). None of the other markers of inflammation and endothelial dysfunction were related to incident hypertension in the cohort. Our data showed that sVCAM-1 as a marker of endothelial dysfunction was the strongest predictor of hypertension risk in individuals with type 1 diabetes. This association was independent of the presence of diabetic nephropathy. Copyright 2010 Mosby, Inc. All rights reserved.

  15. Study of the relationship between aggression and chronic diseases (diabetes and hypertension).

    Science.gov (United States)

    Tilov, Boris; Semerdzhieva, Maria; Bakova, Desislava; Tornyova, Biyanka; Stoyanov, Drozdstoi

    2016-06-01

    This study focused on the widely examined psychosomatic diseases - diabetes mellitus and arterial hypertension as chronic conditions. The Buss-Perry validated questionnaire was used in it to measure aggression in Bulgarian conditions. To study aggression as a predictor and a connection of the chronic diseases diabetes and hypertension. The number of the studied people was 142: 54 (38%) men and 88 (62%) women. Thirty-six of them had musculoskeletal disorders (77.8% women and 22.2% men), 54 had diabetes mellitus (29% women and 25% men) and 52 had hypertension (31% women and 21% men). During the statistical analysis of the data, the results from the Buss-Perry questionnaire were compared in the group of patients with hypertension and diabetes mellitus with chronic diseases, related to musculoskeletal disorders. The study revealed that there was a statistically significant difference in 95% of the cases between anger, hostility in patients with diabetes, hypertension and musculoskeletal disorders. The highest levels of physical aggression were observed in patients with arterial hypertension, M = 17.32 ± 0.86. The highest average levels of verbal aggression were observed in patients with diabetes, M = 15.24 ± 0.64. The highest levels of anger were observed with patients with hypertension, M = 17.96 ± 0.90, and hostility - in patients with hypertension, M = 19.15 ± 0.86. The comparison between the four Aggression Questionnaire scales showed statistically significant differences between the patients with musculoskeletal disorders and the ones with hypertension and diabetes. © 2015 John Wiley & Sons, Ltd.

  16. Morphological substrate of platelet hemostasis damage in patients with type 2 diabetes mellitus and hypertension

    OpenAIRE

    Pertseva N.O.

    2015-01-01

    Background. Disorders of hemostasis in patients with arterial hypertension and diabetes mellitus type 2 are complex: growing aggregative activity of platelets and red blood cells, activation and degranulation of platelet antiaggregatory potential endothelium; reduced anticoagulant and fibrinolytic activity of blood. Objective. The purpose of this study was to determine the morphological changes of blood cells in patients with type 2 diabetes mellitus with hypertension. Methods. Ultrastructura...

  17. Managing hypertension in diabetic patients – focus on trandolapril/verapamil combination

    Directory of Open Access Journals (Sweden)

    Sanjib Kumar Sharma

    2007-09-01

    Full Text Available Sanjib Kumar Sharma1,3, Piero Ruggenenti1,2, Giuseppe Remuzzi1,2, 1Clinical Research Centre for Rare Diseases “Aldo e Cele Daccò”, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica, Italy; 2Unit of Nephrology, Azienda Ospedaliera, Ospedali Riuniti, Bergamo, Italy; 3Department of Medicine, BP Koirala Institute of Health Sciences, Dharan, NepalAbstract: Hypertensive diabetes individuals are at higher risk for cardiovascular events and progression to end stage renal disease. Several well conducted clinical trials indicate that aggressive treatment of hypertension in individual with diabetes reduces these complications. Combinations of two or more antihypertensive drugs are frequently required to reach the target blood pressure and to improve the cardiovascular and renal outcomes in these patients. There are physiological and clinical rationales for renin-angiotensin system blockade in hypertensive diabetics. Trandolapril/verapamil sustained released (SR is a fixed-dose combination of trandolapril and a sustained release formulation of verapamil and indicated in treatment of hypertension in patients who require more than one drug to reach target blood pressure. The antihypertensive efficacy of trandolapril/verapamil SR has been evaluated extensively in large trials. In the INVEST trial, a verapamil SR-based treatment strategy that included trandolapril in most patients was effective in reducing the primary outcome in hypertensive patients with coronary artery disease. The new onset of diabetes was also significantly lower in the verapamil SR/trandolapril treatment group in comparison with those on the atenolol/hydroclorothiazide treatment group. The BErgamo NEphrologic DIabetes Complications Trial (BENEDICT documented that in hypertensive diabetes and normoalbuminuria, trandolapril plus verapamil or trandolapril alone delayed the onset of microalbuminuria independent of their blood pressurereducing effect. Thus

  18. Similarities and differences in early retinal phenotypes in hypertension and diabetes.

    Science.gov (United States)

    Grosso, Andrea; Cheung, Ning; Veglio, Franco; Wong, Tien Yin

    2011-09-01

    The use of retinal photography in clinical practice and research has substantially increased the knowledge about the epidemiology, natural history and significance of diabetic and hypertensive retinopathy. Early retinopathy signs, including retinal microaneurysms, blot hemorrhages, cotton-wool spots and hard exudates, are common vascular abnormalities found in middle-aged to older people with diabetes and hypertension. The presence of these early retinopathy signs is associated with an increased risk of systemic vascular diseases, such as stroke, cognitive impairment, coronary heart disease, heart failure and nephropathy. These retinopathy lesions may therefore be considered as biomarkers of systemic microvascular processes caused by diabetes and hypertension. Nevertheless, whereas the interest in retinopathy assessment continues to grow, a core concept remains undefined: what is the relative importance and contribution of diabetes and hypertension in the development of early retinopathy signs? The answer of this fundamental question holds the key to better understanding of the systemic associations of early hypertensive and diabetic retinopathy. In this review, we summarize the similarities and differences of early retinopathy signs seen in diabetes and hypertension, and discuss the conceptual relevance from epidemiological, pathophysiological, and clinical perspectives.

  19. Artificial neural networks versus bivariate logistic regression in prediction diagnosis of patients with hypertension and diabetes.

    Science.gov (United States)

    Adavi, Mehdi; Salehi, Masoud; Roudbari, Masoud

    2016-01-01

    Diabetes and hypertension are important non-communicable diseases and their prevalence is important for health authorities. The aim of this study was to determine the predictive precision of the bivariate Logistic Regression (LR) and Artificial Neutral Network (ANN) in concurrent diagnosis of diabetes and hypertension. This cross-sectional study was performed with 12000 Iranian people in 2013 using stratified- cluster sampling. The research questionnaire included information on hypertension and diabetes and their risk factors. A perceptron ANN with two hidden layers was applied to data. To build a joint LR model and ANN, SAS 9.2 and Matlab software were used. The AUC was used to find the higher accurate model for predicting diabetes and hypertension. The variables of gender, type of cooking oil, physical activity, family history, age, passive smokers and obesity entered to the LR model and ANN. The odds ratios of affliction to both diabetes and hypertension is high in females, users of solid oil, with no physical activity, with positive family history, age of equal or higher than 55, passive smokers and those with obesity. The AUC for LR model and ANN were 0.78 (p=0.039) and 0.86 (p=0.046), respectively. The best model for concurrent affliction to hypertension and diabetes is ANN which has higher accuracy than the bivariate LR model.

  20. Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus: Overall and Cardiovascular Risk.

    Science.gov (United States)

    Safar, Michel E; Gnakaméné, Jean-Barthélémy; Bahous, Sola Aoun; Yannoutsos, Alexandra; Thomas, Frédérique

    2017-06-01

    Despite adequate glycemic and blood pressure control, treated type 2 diabetic hypertensive subjects have a significantly elevated overall/cardiovascular risk. We studied 244 816 normotensive and 99 720 hypertensive subjects (including 7480 type 2 diabetics) attending medical checkups between 1992 and 2011. We sought to identify significant differences in overall/cardiovascular risk between hypertension with and without diabetes mellitus. Mean follow-up was 12.7 years; 14 050 all-cause deaths were reported. From normotensive to hypertensive populations, a significant progression in overall/cardiovascular mortality was observed. Mortality was significantly greater among diabetic than nondiabetic hypertensive subjects (all-cause mortality, 14.05% versus 7.43%; and cardiovascular mortality, 1.28% versus 0.7%). No interaction was observed between hemodynamic measurements and overall/cardiovascular risk, suggesting that blood pressure factors, even during drug therapy, could not explain the differences in mortality rates between diabetic and nondiabetic hypertensive patients. Using cross-sectional regression models, a significant association was observed between higher education levels, lower levels of anxiety and depression, and reduced overall mortality in diabetic hypertensive subjects, while impaired renal function, a history of stroke and myocardial infarction, and increased alcohol and tobacco consumption were significantly associated with increased mortality. Blood pressure and glycemic control alone cannot reverse overall/cardiovascular risk in diabetics with hypertension. Together with cardiovascular measures, overall prevention should include recommendations to reduce alcohol and tobacco consumption and improve stress, education levels, and physical activity. © 2017 American Heart Association, Inc.

  1. Probiotika og caries

    DEFF Research Database (Denmark)

    Keller, Mette Kirstine

    2017-01-01

    Nærværende artikel præsenterer en oversigt over den foreliggende viden om kostens betydning for diabetes mellitus (DM) og parodontal inflammation. Der er i vekslende grad dokumentation for sammenhænge mellem kost, DM og marginal parodontitis (MP). Med baggrund i forøget viden om kostens betydning...

  2. Sukker og caries

    DEFF Research Database (Denmark)

    Twetman, Svante

    2017-01-01

    Nærværende artikel præsenterer en oversigt over den foreliggende viden om kostens betydning for diabetes mellitus (DM) og parodontal inflammation. Der er i vekslende grad dokumentation for sammenhænge mellem kost, DM og marginal parodontitis (MP). Med baggrund i forøget viden om kostens betydning...

  3. Prevalence of diabetes and hypertension among a tribal population in Tamil Nadu

    Directory of Open Access Journals (Sweden)

    Shankar Radhakrishnan

    2015-01-01

    Full Text Available Background: Diabetes and hypertension is affecting at an alarming rate in both rural and urban populations in India and very few studies had been carried out among the tribal population. Objective: To determine the prevalence rate of type 2 diabetes mellitus and hypertension and its associated risk factors among the tribal population in Salem District in Tamil Nadu. Materials and Methods: A total of about 525 tribal population above 40 years of age from various tribal places in Yercaud. All of them were screened for diabetes, by checking the random blood glucose levels and blood pressure, body mass index, dietary patterns, and physical activity levels were also recorded. Their knowledge about diabetes was also assessed by a set of 10 questions. Results: Among the study population, people who had RBS ΃ 200 was 28 (male = 11 and female = 17 and between 140 and 200 were 39 (male = 18 and female = 21 and people whose were in the prehypertensive stage was 185 (males 92 and female 93 and people in the stage 1 hypertension was 102 (male = 47 and female = 54 and in stage 2 hypertension was 64 (male = 33 and female = 29. The co-morbidity (diabetes and hypertension was present in among 45 (male = 25 and female = 20. Among the study population only 1 was obese and 39 were overweight. Among the various risk factors smoking, alcohol and positive family history were found to have a statistical significant association for males whereas among females only the family history was found to have a statistically significant association for both diabetes and hypertension. The knowledge of diabetes among the study population was very poor. None of them were aware about the normal levels of blood sugar and the risk factors. Conclusion: The study documented that the prevalence of diabetes and hypertension is increasingly high in the tribal areas and their awareness levels were very poor.

  4. Inflammation in the Prediction of Type 2 Diabetes and Hypertension in Healthy Adults.

    Science.gov (United States)

    Sung, Ki-Chul; Ryu, Seungho; Sung, Joo-Wook; Kim, Yong Bum; Won, Yu Sam; Cho, Dong Sik; Kim, Sun H; Liu, Alice

    2017-12-05

    While inflammation is associated with obesity and insulin resistance, their inter-relationships in the development of type 2 diabetes or hypertension are not clear. To evaluate inflammatory markers in prediction of type 2 diabetes and hypertension. The study population of this retrospective cohort study consisted of individuals who participated in a comprehensive health screening program with measurement of white blood cell count and C-reactive protein from 2002-2010 (N = 96,606) in nondiabetic and normotensive Koreans. Median follow up time were 3.7 years for incident type 2 diabetes and 3.3 years for hypertension. Multivariate Cox proportional hazards models were performed to assess risk for type 2 diabetes or hypertension by white blood cell or C-reactive protein quartiles with adjustment of various possible confounding factors including insulin resistance. During the follow-up period, 1448 (1.5%) developed type 2 diabetes and 10,405 (10.8%) developed hypertension. Among men, comparison of adjusted hazard ratios (HR) for incident type 2 diabetes in the highest versus lowest white blood cell or C-reactive protein quartiles were 1.48 [95% confidence interval (CI), 1.20-1.83] and 1.30 (95% CI, 1.07-1.57), respectively. Among women, white blood cell but not C-reactive protein was significantly associated with type 2 diabetes [HR 1.79 (95% CI 1.24-2.57)]. White blood cell and C-reactive protein quartiles were also modestly associated with incident hypertension in both sexes. Although white blood cell and C-reactive protein are associated with adiposity and insulin resistance, these inflammatory markers also independently predict type 2 diabetes and/or hypertension. Copyright © 2017 IMSS. Published by Elsevier Inc. All rights reserved.

  5. Determinants of uncontrolled hypertension in adult type 2 diabetes mellitus: an analysis of the Malaysian diabetes registry 2009

    Directory of Open Access Journals (Sweden)

    Chew Boon How

    2012-05-01

    Full Text Available Abstract Background Uncontrolled blood pressure (BP is a significant contributor of morbidity and even mortality in type 2 diabetes (T2D patients. This study was done to determine the significant determinants of uncontrolled blood pressure in T2D patients in Malaysia. Methods Between 1st January 2009 to 31st December 2009, data from 70 889 patients with Type 2 diabetes was obtained from the Adult Diabetes Control and Management Registry for analysis; 303 centers participated in the study. Their demographic characteristics, the nature of their diabetes, their state of hypertension, treatment modalities, risk factors, and complications are described. Based on their most recent BP values, subjects were divided into controlled BP and uncontrolled BP and their clinical determinants compared. Independent determinants were identified using multivariate logistic regression. Results The mean age of patients at diagnosis of diabetes was 52.3 ± 11.1 years old. Most were women (59.0 % and of Malay ethnicity (61.9 %. The mean duration of diabetes was 5.9 ± 5.6 years. A total of 57.4 % were hypertensive. Of the 56 503 blood pressure (BP measured, 13 280 (23.5 % patients had BP two anti-hypertensive agents. Health clinics without doctor, older age (≥ 50 years old, shorter duration of diabetes ( Conclusions Major independent determinants of uncontrolled BP in our group of T2D patients were Malay ethnicity, older age, recent diagnosis of diabetes, overweight and follow-up at health clinics without a doctor and possibly the improper use of anti hypertensive agent. More effort, education and resources, especially in the primary health care centres are needed to improve hypertensive care among our patients with diabetes.

  6. The influence of type 2 diabetes and arterial hypertension on right ventricular layer-specific mechanics.

    Science.gov (United States)

    Tadic, Marijana; Cuspidi, Cesare; Vukomanovic, Vladan; Ilic, Sanja; Celic, Vera; Obert, Philippe; Kocijancic, Vesna

    2016-10-01

    The aim of the investigation was to evaluate layer-specific right ventricular (RV) deformation in normotensive and hypertensive subjects with type 2 diabetes mellitus (DM). This cross-sectional study included 129 subjects (40 controls, 42 normotensive DM and 47 hypertensive DM patients) who underwent complete two-dimensional echocardiographic examination (2DE) including multilayer strain analysis. 2DE RV global and free wall longitudinal strains were reduced in normotensive and hypertensive DM subjects than in controls. RV global longitudinal layer-specific strains (endo-, mid- and epicardial) were lower in normotensive and hypertensive DM patients than in controls. On the other side, layer-specific strains of RV free wall were lower in hypertensive DM patients than in controls, without significant difference between controls and normotensive DM subjects. Parameters of DM control (fasting glucose and glycosylated hemoglobin) were associated with 2DE RV global longitudinal endo- and mid-myocardial layer strain. Diabetes and hypertension significantly influence RV mechanics assessed by 2DE conventional and 2DE multilayer strain. Hypertension has an additive unfavorable influence on RV deformation in diabetic patients. Laboratory parameters of diabetic control were associated with RV structure, diastolic function and mechanics assessed with complex 2DE strain analysis.

  7. Prevalence of arterial hypertension in diabetic patients before and after the JNC-V

    DEFF Research Database (Denmark)

    Tarnow, L; Rossing, P; Gall, Mari-Anne

    1994-01-01

    OBJECTIVE: To compare the prevalence of arterial hypertension in patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) according to blood pressure (BP) criteria from the World Health Organization (WHO) and The Fifth Report of the Joint Nation...

  8. Predisposition to essential hypertension and development of diabetic nephropathy in IDDM patients

    DEFF Research Database (Denmark)

    Fagerudd, J A; Tarnow, L; Jacobsen, P

    1998-01-01

    of hypertension in this group. However, the difference in prevalence of parental hypertension was not evident using office blood pressure measurements (64 vs. 57%; NS; difference 7% [-5.8-20%). Furthermore, patients with DN+ and with antihypertensive therapy in both parents were themselves more frequently treated......Conflicting results have been reported on the relationship between familial predisposition to hypertension and development of diabetic nephropathy in IDDM. In our case-control study, we assessed the prevalence of hypertension among parents of 73 IDDM patients with diabetic nephropathy (DN......+; persistent albuminuria > 200 microg/min or > 300 mg/24 h) and 73 IDDM patients without diabetic nephropathy (DN-; urinary albumin excretion pressure (SpaceLabs 90207) > or = 135/85 mm...

  9. Pregnancy outcome and placental pathology differences in term gestational diabetes with and without hypertensive disorders.

    Science.gov (United States)

    Kovo, Michal; Granot, Yoav; Schreiber, Letizia; Divon, Michael; Ben-Haroush, Avi; Bar, Jacob

    2016-01-01

    To compare pregnancy outcome and placental pathology in pregnancies complicated by gestational diabetes mellitus (GDM A1 and A2), with and without hypertensive disorders. Pregnancy outcome and placental pathology from term deliveries of women complicated with GDM with (GDM + H) and without (GDM - H) hypertensive disorders were compared. Results of the GDM + H group were compared also with the non-diabetic patients but with hypertensive disorders (non-GDM + H). Composite neonatal outcome was defined as one or more of early complications: respiratory distress or need of ventilation support, sepsis, phototherapy, transfusion, seizure, hypoxic-ischemic encephalopathy. Placental lesions were categorized to lesions related to maternal and fetal vascular supply abnormalities, and maternal and fetal inflammatory responses. Of the 192 women with GDM, the GDM + H group (n = 41) were more obese, p hypertensive disorders, similar to women without DM and with hypertensive complications.

  10. Diabetes Mellitus Associates with Increased Right Ventricular Afterload and Remodeling in Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Whitaker, Morgan E; Nair, Vineet; Sinari, Shripad; Dherange, Parinita; Natarajan, Balaji; Trutter, Lindsey; Brittain, Evan L; Hemnes, Anna R; Austin, Eric; Patel, Kumar; Black, Stephen M; Garcia, Joe G N; Yuan, Jason X; Vanderpool, Rebecca; Rischard, Franz; Makino, Ayako; Bedrick, Edward J; Desai, Ankit A

    2018-02-05

    Diabetes mellitus is associated with left ventricular hypertrophy and dysfunction. Parallel studies have also reported associations between diabetes mellitus and right ventricle dysfunction and reduced survival in patients with pulmonary arterial hypertension. However, the impact of diabetes mellitus on the pulmonary vasculature has not been well-characterized. We hypothesized that diabetes mellitus and hyperglycemia could specifically influence right ventricular afterload and remodeling in patients with Group I pulmonary arterial hypertension, providing a link to their known susceptibility to right ventricular dysfunction. Using an adjusted model for age, gender, pulmonary vascular resistance, and medication use, associations of fasting blood glucose, glycated hemoglobin, and the presence of diabetes mellitus were evaluated with markers of disease severity in 162 patients with pulmonary arterial hypertension. A surrogate measure of increased pulmonary artery stiffness, elevated pulmonary arterial elastance (P=0.012), along with reduced log(pulmonary artery capacitance) (P=0.006) were significantly associated with the presence of diabetes mellitus in patients with pulmonary arterial hypertension in a fully adjusted model. Similar associations between pulmonary arterial elastance and capacitance were noted with both fasting blood glucose and glycated hemoglobin. Furthermore, right ventricular wall thickness on echocardiography was greater in pulmonary arterial hypertension patients with diabetes, supporting the link between right ventricular remodeling and diabetes. Cumulatively, these data demonstrate that an increase in right ventricular afterload, beyond pulmonary vascular resistance alone, may influence right ventricular remodeling and provide a mechanistic link between the susceptibility to right ventricular dysfunction in patients with both diabetes mellitus and pulmonary arterial hypertension. Copyright © 2018. Published by Elsevier Inc.

  11. Assosition of diabetes and hypertension with the incidence of chronic kidney disease: Tehran Lipid and Glucose Study

    OpenAIRE

    Erfanpoor S; Etemad K; Khalili D; Khodakarim S; Kazempoor Ardebili S; Hadaegh F; Azizi F

    2017-01-01

    Background and aims: Chronic kidney disease (CKD) is a common disorder that is associated with increased risk of cardiovascular disease, kidney failure, and other complications. The ageing of populations along with the growing global prevalence of diabetes and hypertension has led to a corresponding worldwide increase in prevalence of CKD. We studied the risk of diabetes, hypertension and interaction of diabetes with hypertension on the incidence of CKD, stratified by gender. Methods: This...

  12. Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Stolzenburg Oxlund, Christina; Henriksen, J. E.; Tarnow, L.

    2013-01-01

    Background:The increased risk of cardiovascular morbidity and mortality associated with arterial hypertension is particularly pronounced in patients with type 2 diabetes mellitus. Blood pressure control is, therefore, decisively important but often not sufficiently achieved.Objective:The primary...... objective of this study was to evaluate the antihypertensive effect of low dose spironolactone added to triple therapy for resistant hypertension in patients with type 2 diabetes measured by ambulatory monitoring. Secondary objectives were to evaluate the effects on glycaemic control and urinary albumin...... diabetes mellitus....

  13. Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie's disease? Analysis in 279 patients with a control group in Sicily

    National Research Council Canada - National Science Library

    Pavone, Carlo; D'Amato, Francesco; Dispensa, Nino; Torretta, Federico; Magno, Carlo

    2015-01-01

    ...), the second one composed by patients with other andrological diseases (control arm). For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function...

  14. Screening of Gestational Diabetes and Hypertension Among Antenatal Women in Rural West India

    Directory of Open Access Journals (Sweden)

    Viral R. Dave

    2014-12-01

    Full Text Available Background: Hypertension and gestational diabetes are among the leading causes of maternal and perinatal mortality, especially in rural areas of developing countries with meager health facilities. With early diagnosis and timely treatment, these adverse events can be decreased. The primary aim of this study was to implement a screening program for gestational diabetes and hypertension, and to assess risk factors associated with these conditions among antenatal women in the rural area of the Gujarat province in India.Methods: A cross–sectional study was conducted at one of the rural areas of Gujarat province in India. Following a random  cluster sampling procedure, the village of Davas was selected. A multistage random sampling method was utilized, resulting in a sample of 346 antenatal women. Screening guidelines from the American Diabetes Association were followed for gestational diabetes screening.Results: The majority of antenatal mothers (55.50% were between 21-25 years of age. 242 antenatal women were multigravida, and among them, 85.96% had institutional delivery at their last pregnancy. Of the total 346 women, 17.60% were prehypertensive. The prevalence of systolic hypertension was 1.40%, diastolic hypertension was 0.90%, and gestational diabetes was 1.73%.Conclusion: Socioeconomically upper class, a family history of hypertension, and BMI ≥ 25 were strong risk factors for hypertension during pregnancy and gestational diabetes. Health education should be made readily available to antenatal mothers by paramedical workers regarding symptoms of hypertension and gestational diabetes mellitus for early self identification.

  15. Prevention of diabetes in hypertensive patients: Results and implications from the VALUE trial

    Directory of Open Access Journals (Sweden)

    Ming-Sheng Zhou

    2009-04-01

    Full Text Available Ming-Sheng Zhou, Ivonne Hernandez SchulmanNephrology-Hypertension Section, Veterans Affairs Medical Center and Division of Nephrology and Hypertension and Vascular Biology institute, University of Miami Miller School of Medicine, Miami, FL, USAAbstract: A growing number of experimental and clinical studies have provided evidence indicating that pharmacological blockade of the renin–angiotensin system (RAS by either angiotensin-converting enzyme inhibitors or angiotensin type 1 receptor blockers reduces the incidence of new onset type 2 diabetes in subjects with hypertension and/or cardiovascular disease, independently of antihypertensive and cardiovascular protective effects. The beneficial effects of RAS inhibition on the development of diabetes have been largely attributed to improvements in peripheral insulin sensitivity and glucose metabolism. This review focuses on recent experimental and clinical evidence supporting the role of RAS inhibition in the reduction of new onset type 2 diabetes and the mechanisms that may be involved.Keywords: renin–angiotensin system, antihypertensive, diabetes

  16. Is hypertension a major independent risk factor for retinopathy in type 1 diabetes?

    DEFF Research Database (Denmark)

    Nørgaard, K; Feldt-Rasmussen, B; Deckert, T

    1991-01-01

    Hypertension is an established risk factor for retinopathy. Whether it is an independent risk factor or acts only by association with nephropathy is not known. Therefore, we studied 273 Type 1 diabetic patients. They were divided into four groups. Group 1 (n = 55) were normotensive...... and normoalbuminuric, group 2 (n = 51) had hypertension but were normoalbuminuric, group 3 (n = 33) had nephropathy but were normotensive, and group 4 (n = 134) had nephropathy and hypertension. Hypertensive patients with normoalbuminuria (blood pressure 146 +/- 19 (+/-SD)/87 +/- 12 mmHg) had the same prevalence...... of retinopathy as normoalbuminuric normotensive patients (123 +/- 12/75 +/- 5 mmHg). Hypertensive nephropathic patients (blood pressure 147 +/- 18/87 +/- 8 mmHg) had more retinopathy than hypertensive normoalbuminuric patients despite similar blood pressure (normal retina/advanced retinopathy: 3%/73% vs 46...

  17. Incident diabetes mellitus, hypertension, and cardiovascular disease risk in exercising hypercholesterolemic patients.

    Science.gov (United States)

    Williams, Paul T; Franklin, Barry A

    2015-11-15

    Exercise may be an important treatment for hypercholesterolemic patients, particularly in statin users who are at increased diabetes risk. We therefore used Cox proportional hazard analyses to compare running and walking dose (metabolic equivalent hours/day [MET-h/d]) to diabetes, hypertension, and cardiovascular disease (CVD) risk in hypercholesterolemic patients. There were 60 diabetic- and 373 CVD-related deaths during a 10.1-year mortality surveillance of 6,688 hypercholesterolemic patients. In addition, there were 177 incident nonfatal diabetes, 815 incident nonfatal hypertensions, and 323 incident nonfatal CVD events during a 6.4-year follow-up of 6,971 hypercholesterolemic patients who supplied follow-up questionnaires. Fatal and nonfatal diabetes risk decreased 26% (p = 0.002) and 19% (p ≤0.0001) per MET-h/d, respectively, and relative to hypertension risk decreased 4% (p = 0.01) per MET-h/d, and relative to diabetes, hypertension, and CVD risk in hypercholesterolemic patients and should more than compensate for the purported 9% increase in diabetes risk from statin use. By preventing morbidity and mortality for a specific existing medical condition, some exercise expenses may qualify for flexible spending account expenditures in hypercholesterolemic patients when prescribed by a physician. Published by Elsevier Inc.

  18. Hypertension og apopleksi

    DEFF Research Database (Denmark)

    Christensen, Hanne; Christensen, Kent Lodberg

    2007-01-01

    Blood pressure changes in the acute phase of stroke are common. High blood pressure is often found on admission as a psychological reaction to stress--a white coat effect. Both high and low blood pressure relate to poor outcome after stroke. At the moment there is no evidence for pharmacological ...

  19. The importance of the relationship between microalbuminuria, subclinical proteinuria and arterial hypertension in diabetics.

    Science.gov (United States)

    Serban, V; Dabelea, D

    1994-01-01

    Arterial hypertension represents, among others, an important risk factor for the development of microalbuminuria in diabetics. On the other hand, with microalbuminuria, it has been observed an important rise in the prevalence of high blood pressure. This study stresses the importance of the relationship between subclinical proteinuria and microalbuminuria, on one hand, and arterial hypertension on the other hand. There have been studied 343 diabetics hospitalized in our Clinic. We estimated the presence of hypertension (according to WHO criteria) and the values of subclinical proteinuria (biuret method) and microalbuminuria (MICRAL-test). We observed that 70.8% of hypertensives and 49.4% of normotensives presented values of proteinuria that ranked between 300 and 500 mg/24 h (p < 0.001). Meanwhile, 25.8% of proteinuric patients and 14.8% of non-proteinuric ones were hypertensives (p < 0.05). In hypertensive diabetics the prevalence of subclinical proteinuria is higher than in normotensive ones. The prevalence of hypertension is significantly higher in microalbuminuric patients than in normoalbuminuric ones.

  20. Relationship of Running Intensity to Hypertension, Hypercholesterolemia, and Diabetes

    Science.gov (United States)

    Williams, Paul T.

    2009-01-01

    Purpose To estimate the independent relationships of running intensity with antihypertensive, LDL-cholesterol–lowering, and antidiabetic medication use when adjusted for running volume (km/d). Methods Self-reported medication use was compared cross-sectionally to running pace (m/s during usual run) in 25,552 male and 29,148 female National Runners’ Health Study participants. Results The men ran a mean ± SD of 5.2 ± 3.1 km/d at 3.3 ± 0.5 m/s (8.3 ± 1.4 min/mile) and the women 4.7 ± 2.9 km/wk at 3.0 ± 0.4 m/s (9.2 ± 1.8 min/mile). When adjusted for kilometers per day, each meter-per second increment in intensity in men and women reduced the odds for antihypertensive drug use by 54% and 46%, respectively, reduced the odds for LDL-cholesterol–lowering medication use by 55% and 48%, respectively, and reduced the odds for antidiabetic medication use by 50% and 75%, respectively (all P antihypertensive, 78% less for LDL-cholesterol lowering, and 67% less for antidiabetic medications (the corresponding odds reductions in women were 61%, 64%, and 87%, respectively, for 8 min/mile or faster versus slower than 11 min/mile). Although usual running pace correlated significantly with a 10-km performance (male, r = 0.55; females, r = 0.49), usual pace remained significantly related to lower use of all three medications in men and antihypertension and antidiabetic medications in women when adjusted for a 10-km performance. Conclusions Although these results do not prove causality, they show that exercise intensity is inversely associated with the prevalence of hypertension, hypercholesterolemia, and diabetes independent of exercise volume and cardiorespiratory fitness (10-km performance), suggesting that the more vigorous the exercise, the healthier the health benefits. PMID:18799983

  1. Associations of Common Variants at APLN and Hypertension in Chinese Subjects with and without Diabetes

    Directory of Open Access Journals (Sweden)

    Rong Zhang

    2012-01-01

    Full Text Available Background. Apelin, the endogenous ligand for the APJ receptor, has a potent hypotensive effect via a nitric oxide-dependent mechanism in vivo. The aim of the study was to investigate the association between the common variants of apelin gene (APLN and hypertension, which was reported recently in a Chinese Han population with and without diabetes. Methods. Three single nucleotide polymorphisms (SNPs on APLN were genotyped in 3156 diabetic patients and 3736 nondiabetic individuals. For non-diabetic subjects, 1779 were enrolled in stage 1 and 1757 were recruited for validation. A meta-analysis combining the two stages was carried out to obtain the overall effect. Results. In diabetic patients, no significant associations of the three SNPs with hypertension were observed. In contrast, we found that rs2235306 was associated with hypertension in non-diabetic males after adjusting for covariates (OR=1.19, P=0.039 while rs2235307 and rs3115759 displayed no evidence of association in both genders. One haplotype, C-C-A, also showed an association with hypertension (OR=1.47, P=0.032 only in men. However, analysis in stage 2 and meta-analysis did not support these findings. Conclusions. We conclude that common variants on APLN are not associated with the prevalence of hypertension in the Chinese.

  2. A guide to the management of blood pressure in the diabetic hypertensive patient.

    Science.gov (United States)

    Shammas, Nicolas W; Sica, Domenic A; Toth, Peter P

    2009-01-01

    Diabetes mellitus and hypertension frequently coexist in patients with the insulin resistance syndrome (IRS). Patients with both diabetes and hypertension typically have widespread endothelial dysfunction, increased oxidative stress, an activated sympathoadrenal system, and an elevated systemic burden of inflammatory mediators. Patients with diabetes and hypertension also have concomitant mixed dyslipidemia and obesity with significant frequency, and are at high risk for the development of macro- and microvascular disease, congestive heart failure, and nephropathy. Current data suggest that ACE inhibitors or angiotensin receptor blockers with or without a diuretic are important, if not preferred, initial therapies for the patient with diabetes and hypertension. Other drug classes such as combined alpha-/beta-adrenoceptor antagonists, dihydropyridine calcium channel antagonists (CCAs), and peripheral alpha-adrenoceptor antagonists are also useful therapeutic options in these patients. In order to optimally reduce the risk for cardiovascular events in the patient with diabetes and hypertension, optimal BP control should be coupled with comprehensive lifestyle modification and aggressive management of dyslipidemia and hyperglycemia.

  3. Diabetes mellitus and hypertension have comparable adverse effects on health-related quality of life

    Directory of Open Access Journals (Sweden)

    Metelko Željko

    2010-01-01

    Full Text Available Abstract Background We aimed to assess health-related quality of life (HRQoL among people with diabetes or hypertension, estimate the effect of cardiovascular comorbidities on HRQoL as well as compare HRQoL in these groups with that of healthy individuals. Methods A total of 9,070 respondents aged 18 years and over were assessed for HRQoL. Data were obtained from the Croatian Adult Health Survey. Respondents were divided into five groups according to their medical history: participants with hypertension (RR, hypertension and cardiovascular comorbidities (RR+, diabetes mellitus (DM, diabetes and cardiovascular comorbidities (DM+ and participants free of these conditions (healthy individuals, HI. HRQoL was assessed on 8 dimensions of the SF-36 questionnaire. Results Participants with diabetes and those with hypertension reported comparably limited (p > 0.05 HRQoL in all dimensions of SF-36, compared with healthy individuals (p 0.05 than participants without such comorbidities (p Conclusion Diabetes and hypertension seem to comparably impair HRQoL. Cardiovascular comorbidities further reduce HRQoL in participants with both chronic conditions. Future research of interventions aimed at improving these participants' HRQoL is needed.

  4. Garlic Increases Antioxidant Levels in Diabetic and Hypertensive Rats Determined by a Modified Peroxidase Method

    Directory of Open Access Journals (Sweden)

    Hana Drobiova

    2011-01-01

    Full Text Available Oxidative damage by free radicals has been implicated in the pathogenesis of vascular disease in diabetes and hypertension. In the present study, the total antioxidant status in diabetic and hypertensive rats before and after treatment with garlic (Allium sativum was determined. The total serum antioxidants were measured by a modified method reported earlier by Miller and coworkers. The reproducibility of the assay was confirmed by determining standard curves for the known antioxidants: trolox (a stable analog of vitamin E, glutathione and vitamin C with interassay correlation coefficients (R2, n = 10 in triplicate of 0.9984, 0.9768 and 0.987, respectively, confirming the reliability and reproducibility of the assay. This assay was then used to determine total serum antioxidant levels of streptozotocin-induced diabetic rats and two-kidney one-clip hypertensive rats both before and after 3 weeks of treatment with an aqueous extract of garlic (500 mg/kg IP daily. The serum antioxidant levels of rats after 3 weeks of treatment were significantly higher (P < .001 than the pretreatment levels in both diabetic and hypertensive rats. The increased serum antioxidant levels were paralleled by a decrease in serum glucose in the garlic-treated diabetic rats and lowered systolic blood pressure in the garlic-treated hypertensive rats. We conclude from our study that (i total antioxidants can be measured by a simple, reproducible, reliable assay and (ii the total antioxidant status can be significantly improved by treatment with garlic.

  5. Transcapillary escape rate of albumin in hypertensive patients with type 1 (insulin-dependent) diabetes mellitus

    DEFF Research Database (Denmark)

    Nørgaard, K; Jensen, T; Feldt-Rasmussen, B

    1993-01-01

    . The systemic blood pressure and the transcapillary escape rate of albumin were measured in the following groups after 4 weeks without antihypertensive treatment: Group 1--eleven healthy control subjects. Group 2--ten Type 1 (insulin-dependent) diabetic patients with incipient nephropathy (urinary albumin...... excretion rate: 30-300 mg/24 h) and normal blood pressure. Group 3--eleven non-diabetic patients with essential hypertension. Group 4--nine Type 1 diabetic patients with hypertension but normal urinary albumin excretion (Type 1 diabetic patients with nephropathy (urinary......Diabetic patients with elevated urinary albumin excretion rate (incipient or clinical nephropathy) also have an increased transcapillary escape rate of albumin. This study was designed to clarify whether this is caused by a general vascular dysfunction or by elevated systemic blood pressure...

  6. Effekter på insulinsekresjon og endotelfunksjon av DPP-IV-hemmeren sitagliptin (Januvia®) hos pasienter som har utviklet diabetes etter nyretransplantasjon.

    OpenAIRE

    Halden, Thea Anine Strøm

    2012-01-01

    Introduksjon: Nyretransplanterte pasienter er i stor grad utsatt for kardiovaskulære sykdommer som hypertensjon, dyslipidemi, endoteldysfunksjon samt nedsatt glukosetoleranse (IGT)/nyoppstått diabetes etter transplantasjon (NODAT). Disse pasientene har en høyere risiko for prematur kardiovaskulær sykdom og død enn den generelle populasjonen. Behandling av diabetes i nyretransplanterte pasienter samt pasienter med nyresvikt representerer en utfordring. Sitagliptin (Januvia®) er en dipeptidylpe...

  7. Determinants of uncontrolled hypertension in adult type 2 diabetes mellitus: an analysis of the Malaysian diabetes registry 2009.

    Science.gov (United States)

    Chew, Boon How; Mastura, Ismail; Shariff-Ghazali, Sazlina; Lee, Ping Yein; Cheong, Ai Theng; Ahmad, Zaiton; Taher, Sri Wahyu; Haniff, Jamaiyah; Mustapha, Feisul Idzwan; Bujang, Mohd Adam

    2012-05-18

    Uncontrolled blood pressure (BP) is a significant contributor of morbidity and even mortality in type 2 diabetes (T2D) patients. This study was done to determine the significant determinants of uncontrolled blood pressure in T2D patients in Malaysia. Between 1st January 2009 to 31st December 2009, data from 70 889 patients with Type 2 diabetes was obtained from the Adult Diabetes Control and Management Registry for analysis; 303 centers participated in the study. Their demographic characteristics, the nature of their diabetes, their state of hypertension, treatment modalities, risk factors, and complications are described. Based on their most recent BP values, subjects were divided into controlled BP and uncontrolled BP and their clinical determinants compared. Independent determinants were identified using multivariate logistic regression. The mean age of patients at diagnosis of diabetes was 52.3 ± 11.1 years old. Most were women (59.0 %) and of Malay ethnicity (61.9 %). The mean duration of diabetes was 5.9 ± 5.6 years. A total of 57.4 % were hypertensive. Of the 56 503 blood pressure (BP) measured, 13 280 (23.5 %) patients had BP two anti-hypertensive agents. Health clinics without doctor, older age (≥ 50 years old), shorter duration of diabetes (< 5 years), Malay, overweight were determinants for uncontrolled blood pressure (BP ≥130/80 mmHg). Patients who were on anti-hypertensive agent/s were 2.7 times more likely to have BP ≥130/80 mmHg. Type 2 diabetes patients who had ischaemic heart disease or nephropathy were about 20 % and 15 % more likely to have their blood pressure treated to target respectively. Major independent determinants of uncontrolled BP in our group of T2D patients were Malay ethnicity, older age, recent diagnosis of diabetes, overweight and follow-up at health clinics without a doctor and possibly the improper use of anti hypertensive agent. More effort, education and resources, especially in the primary health care centres are

  8. Neighborhood Social Cohesion and Prevalence of Hypertension and Diabetes in a South Asian Population.

    Science.gov (United States)

    Lagisetty, Pooja A; Wen, Ming; Choi, Hwajung; Heisler, Michele; Kanaya, Alka M; Kandula, Namratha R

    2016-12-01

    South Asians have a high burden of cardiovascular disease compared to other racial/ethnic groups in the United States. Little has been done to evaluate how neighborhood environments may influence cardiovascular risk factors including hypertension and type 2 diabetes in this immigrant population. We evaluated the association of perceived neighborhood social cohesion with hypertension and type 2 diabetes among 906 South Asian adults who participated in the Mediators of Atherosclerosis in South Asians Living in America Study. Multivariable logistic regression adjusted for demographic, socioeconomic, psychosocial, and physiologic covariates. Subgroup analyses examined whether associations differed by gender. South Asian women living in neighborhoods with high social cohesion had 46 % reduced odds of having hypertension than those living in neighborhoods with low social cohesion (OR 0.54, 95 % CI 0.30-0.99). Future research should determine if leveraging neighborhood social cohesion prevents hypertension in South Asian women.

  9. Prevalence of arterial hypertension in diabetic patients before and after the JNC-V

    DEFF Research Database (Denmark)

    Tarnow, L; Rossing, P; Gall, Mari-Anne

    1994-01-01

    OBJECTIVE: To compare the prevalence of arterial hypertension in patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) according to blood pressure (BP) criteria from the World Health Organization (WHO) and The Fifth Report of the Joint National....... The corresponding rises in NIDDM patients were from 51 to 71% (normo-), from 73 to 90% (micro-), and from 82 to 93% (macroalbuminuria). Of the untreated hypertensive patients, 78% of IDDM patients and 50% of NIDDM patients had stage 1 (140-159/90-99 mmHg) hypertension; 20% of IDDM patients and 37% of NIDDM patients...... in a population of IDDM and NIDDM patients. Isolated systolic hypertension contributes importantly....

  10. Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus.

    Science.gov (United States)

    Heida, Karst Y; Franx, Arie; van Rijn, Bas B; Eijkemans, Marinus J C; Boer, Jolanda M A; Verschuren, Monique W M; Oudijk, Martijn A; Bots, Michiel L; van der Schouw, Yvonne T

    2015-12-01

    A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of hypertension and T2D. Between 1993 and 1997, 22 265 ever-pregnant women were included from the European Prospective Investigation into Cancer and Nutrition-NL study, aged 20 to 70 years at baseline. Details on complications of pregnancy and known hypertension were obtained by questionnaire. Blood pressure was measured at enrollment. Participants were followed for the occurrence of CVD events. Data were analyzed using ANCOVA, multivariable logistic regression, and Cox proportional hazard (with HDP and GDM as time-dependent variables for T2D and CVD) models. At enrollment, women with a HDP reported diagnosis of hypertension 7.7 years earlier (95% confidence interval [CI] 6.9-8.5) and women with GDM reported diagnosis of T2D 7.7 years earlier (95% CI 5.8-9.6) than women without pregnancy complications. After adjustment for potential confounders, HDP was associated with presence of hypertension at enrollment (odds ratio 2.12, 95% CI 1.98-2.28) and onset of CVD later in life (hazard ratio 1.21, 95% CI 1.10-1.32). After including the intermediates hypertension and T2D in the model, the risk of CVD later in life decreased (hazard ratio 1.09, 95% CI 1.00-1.20). GDM was associated with an increased risk of developing T2D later in life (hazard ratio 3.68, 95% CI 2.77-4.90), but not with risk of CVD. HDP and GDM have a substantial impact on the risk of CVD and are potentially important indicators for preventive cardiovascular risk management. © 2015 American Heart Association, Inc.

  11. Aggressive antihypertensive strategies based on hydrochlorothiazide, candesartan or lisinopril decrease left ventricular mass and improve arterial compliance in patients with type II diabetes melllitus and hypertension

    NARCIS (Netherlands)

    Spoelstra-de Man, A.M.; van Ittersum, F.J.; Schram, M.T.; Kamp, O.; van Dijk, R.; IJzerman, R.G.

    2006-01-01

    We investigated the effects of aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril on left ventricular mass (LVM) index and arterial stiffness in hypertensive type II diabetic individuals. Seventy hypertensive type II diabetic individuals were treated with

  12. Aggressive antihypertensive strategies based on hydrochlorothiazide,candesartan or lisinopril decrease left ventricular mass and improve arterial compliance in patients with type II diabetes mellitus and hypertension

    NARCIS (Netherlands)

    Spoelstra-de Man, A.M.; van Ittersum, F.J.; van Meeteren-Schram, M.T.; Kamp, O.; van Dijk, R.A.; IJzerman, R.G.; Twisk, J.W.; Brouwer, C.B.; Stehouwer, C.D.A.

    2006-01-01

    We investigated the effects of aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril on left ventricular mass (LVM) index and arterial stiffness in hypertensive type II diabetic individuals. Seventy hypertensive type II diabetic individuals were treated with

  13. Simultaneous control of diabetes mellitus, hypertension, and hyperlipidemia in 2 health systems.

    Science.gov (United States)

    Schroeder, Emily B; Hanratty, Rebecca; Beaty, Brenda L; Bayliss, Elizabeth A; Havranek, Edward P; Steiner, John F

    2012-09-01

    Many individuals with diabetes mellitus, hypertension, and hyperlipidemia have difficulty achieving control of all 3 conditions. We assessed the incidence and duration of simultaneous control of hyperglycemia, blood pressure, and low-density lipoprotein cholesterol in patients from 2 health care systems in Colorado. We performed a retrospective cohort study of adults at Denver Health and Kaiser Permanente Colorado with diabetes mellitus, hypertension, and hyperlipidemia from 2000 through 2008. Over a median of 4.0 and 4.4 years, 16% and 30% of individuals at Denver Health and Kaiser Permanente achieved the primary outcome (simultaneous control with a glycosylated hemoglobin (HbA(1c)) diabetes mellitus, hypertension, and hyperlipidemia was uncommon and generally transient. Less stringent goals had a relatively large effect on the proportion achieving simultaneous control. Individuals who simultaneously achieve multiple treatment goals may provide insight into self-care strategies for individuals with comorbid health conditions.

  14. Management of Hypertension and Diabetes in Obesity: Non-Pharmacological Measures

    Directory of Open Access Journals (Sweden)

    Joseph M. Pappachan

    2011-01-01

    Full Text Available Obesity has become a global epidemic over the past few decades because of unhealthy dietary habits and reduced physical activity. Hypertension and diabetes are quite common among obese individuals and there is a linear relationship between the degree of obesity and these diseases. Lifestyle interventions like dietary modifications and regular exercise are still important and safe first-line measures for treatment. Recently, bariatric surgery has emerged as an important and very effective treatment option for obese individuals especially in those with comorbidities like hypertension and diabetes. Though there are few effective drugs for the management of obesity, their efficacy is only modest, and they should always be combined with lifestyle interventions for optimal benefit. In this paper we aim to outline the non-pharmacological measures for the management of hypertension and diabetes in obesity.

  15. Cigarette smoking, hypertension and diabetes mellitus as risk factors for erectile dysfunction in upper Egypt.

    Science.gov (United States)

    Zedan, H; Hareadei, A A; Abd-Elsayed, A A; Abdel-Maguid, E M

    2010-03-01

    Erectile dysfunction impairs the quality of life of millions of men worldwide. This study aims to determine the relationship between selected clinical risk factors and erectile dysfunction in men residing in upper Egypt. Patients were surveyed with the 5-item International Index of Erectile Function (IIEF-5) and assessed for the presence of hypertension, diabetes and smoking. Of 658 men with erectile dysfunction, 17.3% had hypertension, 21.4% had diabetes and 40.1% were smokers, whereas among 821 age-matched controls without erectile dysfunction, the corresponding figures were 2.8%, 3.7% and 28.7%. Multivariate analysis showed that hypertension (OR = 5.4), diabetes mellitus (OR = 5.4) and smoking (OR = 3.1) were significant risk factors for erectile dysfunction.

  16. Impact of hypertension on various markers of subclinical atherosclerosis in early type 2 diabetes.

    Science.gov (United States)

    Alatab, Sudabeh; Fakhrzadeh, Hossein; Sharifi, Farshad; Mostashfi, Ali; Mirarefin, Mojde; Badamchizadeh, Zohreh; Tagalizadehkhoob, Yaser

    2014-01-29

    Presence of Diabetes Mellitus increases the risk of subclinical atherosclerosis. In this study was aimed to determine the influence of hypertension (HTN) on surrogate markers of atherosclerosis in a population of patients with early type 2 diabetes. 125 diabetic subjects drawn from Dr. Shariati outpatient's clinic list and 153 non- diabetic subjects who were the relatives in law of diabetic participants were recruited. Participants with type 2 diabetes were free of clinical evidence of cardiovascular disease and renal involvement. Two groups of diabetic and control were further divided into two subgroups of hypertensive (known case of HTN or blood pressure ≥140/90 mmHg) and normotensive, and anthropometric characteristics, metabolic biomarkers as well as markers of subclinical atherosclerosis including Carotid intima media thickness (CIMT), flow mediated dilation (FMD) and Ankle Brachial Index (ABI) were measured. Diabetic group with a mean age of 49.9 ± 7.5 years had significantly higher CIMT (0.64 ± 0.14 vs 0.76 ± 0.19, p = 0.001) and lower FMD (16.5 ± 8.1 vs 13.3 ± 7.1, p = 0.003) and ABI (1.2 ± 0.1 vs 1.1 ± 0.1, p = 0.01) than control with mean age of 52.9 ± 10.1 years. 34% of control and 59.2% of diabetic were hypertensive. Fasting blood sugar, insulin levels and calculated insulin resistance index of HOMA IR. of hypertensive subjects were higher than normotensive subjects in both groups of diabetic and non-diabetic. Similar pattern was presented for measured inflammatory mediators of hs-CRP and IL-6. Among subclinical atherosclerosis markers, only CIMT was significantly different between hypertensive and normotensive subjects in both groups. In adjusted linear regression analysis, a constant significant association existed between age and CIMT, ABI and FMD in non-diabetic, while in diabetic, age only correlated with CIMT and not the other two markers. In multiple regression model, HTN was recognized as

  17. PROSPECTIVE STUDY OF THYROID FUNCTION AND ITS CORRELATION WITH LIPID PARAMETER IN PATIENTS WITH DIABETES AND HYPERTENSIVE DIABETES

    Directory of Open Access Journals (Sweden)

    Kumar Prafull Chandra

    2016-12-01

    Full Text Available BACKGROUND Abnormality in lipid and thyroid function is commonly observed in patients with type 2 diabetes mellitus. Both hypothyroidism and hyperthyroidism are the reasons to develop secondary dyslipidaemia. The aim of the study is to study the thyroid function and its correlation with the lipid parameters in patients with diabetes and hypertensive diabetics. MATERIALS AND METHODS A prospective study was done on 141 diabetic patients in the Department of Medicine, Mayo Institute of Medical Sciences, Barabanki, between February 2016 to June 2016. All patients were divided into Group D (n=42, patients having diabetes only and Group HD (n=99, patients having diabetes with hypertension. Detailed demographic parameters, glycaemic parameters including Fasting Plasma Glucose (FPG, Postprandial Glucose (PPG, HbA1c and average blood glucose were estimated. Thyroid function test viz. T3, T4 and TSH along with lipid parameters were estimated for all the patients. RESULTS Out of 141 patients, 29.78% were having diabetes alone, whereas 70.21% were having hypertension with diabetes. There were 80.95% males in patients with diabetes, whereas there were 76.76% males among hypertensive diabetics. All the demographic, glycaemic and lipid parameters were comparable between both the groups except age (p=0.0001, HbA1c (p=0.001 and average blood glucose (p=0.023. Thyroid function test was also comparable between both the groups, but correlation of lipid parameters with the thyroid function test parameters has revealed that LDL-C was significantly positively correlated with T3 (r=0.303, p=0.0004, T4 (r=0.181, p=0.036 and TSH (r=0.184, p=0.034. VLDL-C was also significantly positively correlated with the T3 (r=0.201, p=0.021. CONCLUSION Positive correlation was obtained between LDL-C and T3, T4 and TSH and VLDL-C with T3, which highlight the importance of screening thyroid function among diabetes patients with or without hypertension.

  18. Hypertension awareness, treatment, and control among diabetic and nondiabetic individuals in a multiethnic population in the Netherlands: the HELIUS study

    NARCIS (Netherlands)

    Fernald, Florence F.; van den Born, Bert-Jan H.; Snijder, Marieke B.; Brewster, Lizzy M.; Peters, Ron J.; Agyemang, Charles

    2016-01-01

    There is a paucity of data on hypertension awareness, treatment and control among diabetic adults from different ethnic backgrounds. We assessed ethnic differences in prevalence, awareness, treatment, and control of hypertension among diabetic adults and how they are compared with individuals

  19. Do diabetes mellitus and systemic hypertension predispose to left ventricular free wall rupture in acute myocardial infarction?

    DEFF Research Database (Denmark)

    Melchior, T; Hildebrant, P; Køber, L

    1997-01-01

    Diabetes and systemic hypertension had no influence on left ventricular free wall rupture complicating acute myocardial infarction. Age <65 years and a history of coronary artery disease offers some protection from protection.......Diabetes and systemic hypertension had no influence on left ventricular free wall rupture complicating acute myocardial infarction. Age

  20. Relationship between hypertension, diabetes and proteinuria in rural and urban households in Yemen

    Science.gov (United States)

    Modesti, P A; Bamoshmoosh, M; Rapi, S; Massetti, L; Bianchi, S; Al-Hidabi, D; Al Goshae, H

    2013-01-01

    Little information is available on the meanings of proteinuria in low-resource settings. A population-based, cross-sectional survey was performed in Yemen on 10 242 subjects aged 15–69 years, stratified by age, gender and urban/rural residency. Hypertension is defined as systolic blood pressure (BP) of ⩾140 mm Hg and/or diastolic BP of ⩾90 mm Hg, and/or self-reported use of antihypertensive drugs; diabetes is diagnosed as fasting glucose of ⩾126 mg dl−1 or self-reported use of hypoglycaemic medications; proteinuria is defined as ⩾+1 at dipstick urinalysis. Odds ratios (ORs) for associations were determined by multivariable logistic regression models. Prevalence (weighted to the Yemen population aged 15–69 years) of hypertension, diabetes and proteinuria were 7.5, 3.7 and 5.1% in urban, and 7.8, 2.6 and 7.3% in rural locations, respectively. Proteinuria and hypertension were more prevalent among rural dwellers (adjusted ORs 1.56; 95% confidence limit (Cl) 1.31–1.86, and 1.23; 1.08–1.41, respectively), diabetes being less prevalent in rural areas (0.70; 0.58–0.85). Differently from hypertension and diabetes, proteinuria was inversely related with age. Most importantly, 4.6 and 6.1% of urban and rural dwellers, respectively, had proteinuria in the absence of hypertension and diabetes. The approach of considering kidney damage as a consequence of hypertension and diabetes might limit the effectiveness of prevention strategies in low-income countries. PMID:23514843

  1. Dietary supplements in the management of hypertension and diabetes - a review.

    Science.gov (United States)

    Afolayan, Anthony Jide; Wintola, Olubunmi Abosede

    2014-01-01

    The use of alternative therapies like herbs and dietary supplements is very common among hypertensive and diabetic patients all over the globe. Hypertension is a silent disease that causes increase in cardiovascular, cerebrovascular, renal morbidity and mortality whereas diabetic complications cause heart attack, stroke, blindness and kidney disease. These are serious and chronic metabolic disorders that have a significant impact on the health, quality of life, and life expectancy of patients, as well as on the health care systems. Orthodox drugs used for the treatment of hypertension and diabetes produce side effects such as headache, nausea, vomiting, stomach pain, constipation, diarrhea, weakness, fatigue and erectile dysfunction. The need for considering alternate therapies in the form of dietary supplements known to promote good health, having little or no side effects therefore arises. This review was carried out using comprehensive and systematic literature reports on the concurrent use of dietary supplements in the management of diabetes and hypertension. Empirical searches were conducted using Google scholar (http://scholar.google.com), and Science Direct (http://www.sciencedirect.com). In addition to these databases, the University database was also used. Searches were also undertaken using keyword combinations such as dietary supplements and the names of the diseases in question. This review chronicled the therapeutic values of vitamins, minerals, amino acids, fruits, vegetables, herbs and other botanicals used as dietary supplements. Results show that these supplements provided better and safe substitutes to toxic and expensive conventional drugs. Generally dietary supplements are free from major side effects, readily available and affordable. It is envisaged that the use of dietary supplement will promote good health and improve the status of hypertensive and diabetic patients. Medical doctors are therefore encouraged to incorporate dietary supplements

  2. Tooth element levels indicating exposure profiles in diabetic and hypertensive subjects from Mysore, India.

    Science.gov (United States)

    Nagaraj, G; Sukumar, A; Nandlal, B; Vellaichamy, S; Thanasekaran, K; Ramanathan, A L

    2009-12-01

    Element contents of teeth elucidate exposure nature, but less is known about association of tooth element concentrations of diabetics and hypertensives with exposure profile. Present study aims to estimate copper, chromium, iron, zinc, nickel, and lead concentrations in the permanent teeth of control, diabetic, and hypertensive subjects from Mysore. The results show that lead levels of teeth (Pb-T) are higher in the hypertensives and diabetics, whereas copper levels of teeth (Cu-T) are lower in the hypertensives and users of stainless steel utensils than that of controls and users of mixed utensils. The elevated Cu-T levels found in the users of mixed utensils that being made of several metals are ascribed to leaching effect of sour and spicy food of Indian cuisine. The element levels were influenced by diet (Zn-T), place of living, sex and income (Pb-T) of the subjects, but not by age, drinking water from different sources, and certain habits viz., smoking, alcohol consumption, chewing betel, and nut. Thus, it is evident that high Pb-T and low Cu-T levels may be related with diabetes and hypertension and high Pb-T and Cu-T levels, respectively, in the urbanites, and the users of mixed utensils may show different exposure profiles from environment and utensils.

  3. Vejledning i diagnostik af type 2-diabetes (Udredning, diagnostik og glukosemåling)

    DEFF Research Database (Denmark)

    Borch-Johnsen, K.; Beck-Nielsen, Henning; Christiansen, J.S.

    2003-01-01

    individuals with either previous gestational diabetes; obesity (BMI > 30 kg/m2) and/or two or more relatives with diabetes should be considered eligible for testing for diabetes. In order to make the diagnosis two diabetic glucose values on separate days are required. The diagnosis may be made using plasma...

  4. Vejledning i diagnostik af type 2-diabetes. Udredning, diagnostik og glukosemåling

    DEFF Research Database (Denmark)

    Borch-Johnsen, Knut; Beck-Nielsen, Henning; Christiansen, Jens Sandahl

    2003-01-01

    individuals with either previous gestational diabetes; obesity (BMI > 30 kg/m2) and/or two or more relatives with diabetes should be considered eligible for testing for diabetes. In order to make the diagnosis two diabetic glucose values on separate days are required. The diagnosis may be made using plasma...

  5. Endogenous Peptide Apelin and Pathological Cardiac Remodeling in Hypertensive Patients with Diabetes Mellitus Type 2

    Directory of Open Access Journals (Sweden)

    S.M. Koval

    2015-08-01

    Full Text Available The study involved 63 patients with essential hypertension and diabetes mellitus type 2. The control group consisted of 16 apparently healthy individuals. Complex of examination included conventional clinical-laboratory and instrumental methods, ultrasound of the heart with Doppler sonography, determining apelin blood concentration by ELISA. Patients with essential hypertension and diabetes mellitus type 2 compared with the control group had a probable reduction in apelin level associated with the development of pathological cardiac remodeling, increasing the size of the left atrium and diastolic dysfunction of the heart.

  6. Hypertensive patients and diabetes : A high-risk population

    NARCIS (Netherlands)

    Bilo, HJG; Gans, ROB

    1998-01-01

    Rising worldwide rates of diabetes mellitus heighten the need to maintain adequate metabolic control in diabetic patients and to control for other cardiovascular risk factors, such as lipid profile disturbances, high blood pressure, and smoking habits. This is especially the case in diabetic

  7. Family clustering of secondary chronic kidney disease with hypertension or diabetes mellitus. A case-control study.

    Science.gov (United States)

    de Almeida, Fernando Antonio; Ciambelli, Giuliano Serafino; Bertoco, André Luz; Jurado, Marcelo Mai; Siqueira, Guilherme Vasconcelos; Bernardo, Eder Augusto; Pavan, Maria Valeria; Gianini, Reinaldo José

    2015-02-01

    In Brazil hypertension and type 2 diabetes mellitus are responsible for 60% of cases of end-stage renal disease in renal replacement therapy. In the United States studies have identified family clustering of chronic kidney disease, predominantly in African-Americans. A single Brazilian study observed family clustering among patients with chronic kidney disease when compared with hospitalized patients with normal renal function. This article aims to assess whether there is family clustering of chronic kidney disease in relatives of individuals in renal replacement therapy caused by hypertension and/or diabetes mellitus. A case-control study with 336 patients in renal replacement therapy with diabetes mellitus or hypertension for at least 5 years (cases) and a control matched sample group of individuals with hypertension or diabetes mellitus and normal renal function (n = 389). Individuals in renal replacement therapy (cases) had a ratio of 2.35 (95% CI 1.42-3.89, p hypertension or diabetes mellitus).

  8. The association between hypertension and diabetes in a Family Health Center

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    Daniele Braz da Silva

    2011-03-01

    Full Text Available Objective: To describe the clinical characteristics of patients with hypertension treated in a health unit and its association with diabetes, relating to sex and age. Methods: We conducted this quantitative and documentary research with 297 registered users in the Plan of Reorganization of Care for Hypertension and Diabetes Mellitus (HIPERDIA / MS of a Family Health Center of the Regional Executive Office VI (SER VI at Fortaleza -Ceará, in May 2009. The sample was divided according to gender, age and relationship betweenhypertension and diabetes. Results: We found a predominance of women, over 40 years, with hypertension and without diabetes. Fifty-eight (19.5% users had hypertension and diabetes associated, suggesting an additional risk factor, relevant to this clientele. One hundredand fifty-five (52.2% of hypertensive patients, with and without diabetes, controlled blood pressure and among those who were not in control, 85 (28.6% were elderly. It was identified that 46 (15.5% users were affected by some complication, especially the stroke as the most prevalent among female 13 (52% and acute myocardial infarction in male 11 (38%. The antihypertensive drugs and hypoglycemic most used were 170 (71.1% hydrochlorothiazide,44 (75.9% glibenclamide and 04 (6.9% insulin. Conclusion: High blood pressure affects men and women, and its prevalence increases with age. When associated with diabetes, increases the risk of developing cardiovascular disease. It is believed that the education of individuals with chronic illness is the best way to reduce these harms.

  9. The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations

    Directory of Open Access Journals (Sweden)

    Mutsa P. Mutowo

    2016-01-01

    Full Text Available Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe. Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models. Results. The median cost and interquartile range (IQR for patients with diabetes, $994 (385–1553 mean $1319 (95% CI: 981–1657, was higher than patients with hypertension, $759 (494–1147 mean $914 (95% CI: 825–1003. Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828. Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149 for patients with diabetes and $2239 (95% CI: 1589–3156 for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy, the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs. Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities.

  10. Relationship between blood pressure reverse dipping and type 2 diabetes in hypertensive patients.

    Science.gov (United States)

    Sun, Lu; Yan, Bin; Gao, Ya; Su, Dan; Peng, Liyuan; Jiao, Yang; Wang, Yuhuan; Han, Donggang; Wang, Gang

    2016-04-25

    Recent studies suggested that nocturnal variations of blood pressure (BP) were closely related to type 2 diabetes. However, little information has been revealed about the relationship between reverse-dipper pattern of BP and type 2 diabetes. In this cross-sectional study, BP variations of 531 hypertensive patients were evaluated with ambulatory BP monitoring (ABPM). Diagnosis of diabetes in Chinese adults was made according to diabetes diagnostic criteria of 2015. Multivariate logistic regression was used to examine the relationships between type 2 diabetes and ABPM results. In the study, patients with reverse-dipper pattern (32.3%) had the highest prevalence of type 2 diabetes compared with dippers (21.4%) and nondippers (23.3%). After multivariate logistic regression, reverse-dipper BP pattern (OR 2.067, P = 0.024) and nondipper BP pattern (OR 1.637, P = 0.039) were found to be correlated with type 2 diabetes compared with dipper pattern. The results of our study also suggested that type 2 diabetes might contribute to the reverse-dipper pattern of BP (OR 1.691, P = 0.023). In addition, fasting glucose was negatively correlated with the decline rate of nocturnal SBP (r = -0.095, P = 0.029). Reverse-dipper pattern of BP in ABPM may be independently associated with type 2 diabetes in patients with hypertension.

  11. A comparison of spirapril and isradipine in patients with diabetic nephropathy and hypertension

    DEFF Research Database (Denmark)

    Nørgaard, K; Jensen, T; Christensen, P

    1993-01-01

    The effects of spirapril and isradipine on blood pressure, urinary albumin excretion and sodium-volume homeostasis in hypertensive insulin-dependent diabetic patients with nephropathy were assessed. Fifteen Type 1 diabetic patients aged 28-53 years with a diabetes duration of 19-37 years were...... studied. All had hypertension and diabetic nephropathy with a urinary albumin excretion of more than 300 mg/24 h. After a single blind placebo treatment period of 4 weeks the patients were randomly assigned to treatment with the calcium antagonist isradipine SRO 5 mg once daily or the ACE inhibitor...... spirapril 6 mg once daily for 6 months in a double-blind design. Isradipine lowered ambulatory systolic blood pressure from 152 +/- 12 to 141 +/- 11 mmHg (p blood pressure lowering effect of spirapril was similar: 156...

  12. The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria.

    Science.gov (United States)

    Isara, Alphonsus Rukevwe; Okundia, Patrick Otamere

    2015-01-01

    The African region of the world is experiencing a double epidemic of both communicable and non-communicable diseases. The objective of the study was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria. A community based descriptive cross-sectional study. Adults aged 18 years and above residing in the rural communities who attended a free medical outreach programme were screened for hypertension and diabetes mellitus. Data were collected using a structured interviewer-administered questionnaire. Of the 845 participants, 349 (41.3%) were aged 50-69 years, 263 (31.1%) were males, and 305 (36.1%) were farmers. Overweight and obesity were found in 184 (21.8%) and 90 (10.6%) of them respectively. The overall prevalence of hypertension was 37.6% (males 43.7%, females 35.1%, p = 0.018) while that of diabetes mellitus was 4.6% (males 1.9%, females 5.8%, p = 0.012). Predictors of hypertension were age ≥ 40 years (OR = 5.04, CI: 2.99 - 8.48), overweight/obesity (OR = 1.56, CI: 1.15 - 2.13) while females are less likely to develop hypertension (OR = 0.72, CI: 0.53 - 0.98). The significant predictor of diabetes mellitus was overweight/obesity (OR = 3.53, CI: 1.78 - 6.98). The rising prevalence of hypertension and diabetes mellitus is assuming an epidemic level in rural communities in southern Nigeria. There is an urgent need for intensive health education and community surveillance programmes targeted at rural communities in order to achieve prevention and control of these non-communicable diseases in Nigeria.

  13. Hypertension in diabetes as related to nephropathy. Early blood pressure changes

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B; Borch-Johnsen, K; Mathiesen, E R

    1985-01-01

    and elevated urinary albumin excretion rate 20 to 200 micrograms/min; and group 3, patients with Albustix-positive urine at the time of diagnosis of diabetic nephropathy, that is, proteinuria greater than 0.5 g/24 hr on four consecutive visits with an interval of more than 1 month. We also studied blood...... that arterial hypertension is an early feature in the developing of diabetic nephropathy, with blood pressure rising before the presence of clinical proteinuria....

  14. Hypertension is a conditional factor for the development of cardiac hypertrophy in type 2 diabetic mice.

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    Marc van Bilsen

    Full Text Available BACKGROUND: Type 2 diabetes is frequently associated with co-morbidities, including hypertension. Here we investigated if hypertension is a critical factor in myocardial remodeling and the development of cardiac dysfunction in type 2 diabetic db/db mice. METHODS: Thereto, 14-wks-old male db/db mice and non-diabetic db/+ mice received vehicle or angiotensin II (AngII for 4 wks to induce mild hypertension (n = 9-10 per group. Left ventricular (LV function was assessed by serial echocardiography and during a dobutamine stress test. LV tissue was subjected to molecular and (immunohistochemical analysis to assess effects on hypertrophy, fibrosis and inflammation. RESULTS: Vehicle-treated diabetic mice neither displayed marked myocardial structural remodeling nor cardiac dysfunction. AngII-treatment did not affect body weight and fasting glucose levels, and induced a comparable increase in blood pressure in diabetic and control mice. Nonetheless, AngII-induced LV hypertrophy was significantly more pronounced in diabetic than in control mice as assessed by LV mass (increase +51% and +34%, respectively, p<0.01 and cardiomyocyte size (+53% and +31%, p<0.001. This was associated with enhanced LV mRNA expression of markers of hypertrophy and fibrosis and reduced activation of AMP-activated protein kinase (AMPK, while accumulation of Advanced Glycation End products (AGEs and the expression levels of markers of inflammation were not altered. Moreover, AngII-treatment reduced LV fractional shortening and contractility in diabetic mice, but not in control mice. CONCLUSIONS: Collectively, the present findings indicate that type 2 diabetes in its early stage is not yet associated with adverse cardiac structural changes, but already renders the heart more susceptible to hypertension-induced hypertrophic remodeling.

  15. Arterial stiffness evaluation by cardio-ankle vascular index in hypertension and diabetes mellitus subjects.

    Science.gov (United States)

    Wang, Hongyu; Liu, Jinbo; Zhao, Hongwei; Fu, Xiaobao; Shang, Guangyun; Zhou, Yingyan; Yu, Xiaolan; Zhao, Xujing; Wang, Guang; Shi, Hongyan

    2013-01-01

    Arterial stiffness is an independent predictor for vascular diseases. Cardio-ankle vascular index (CAVI) is a new index of arterial stiffness. In the present study, we investigated the possible risk factors involving CAVI in hypertension and diabetes mellitus (DM) subjects. One thousand sixty-three subjects (M/F 533/530) from Shougang Corporation Examination Center were divided into four groups: healthy group (n = 639); hypertension group (n = 312); DM group (n = 58); and hypertension with DM group (n = 54). CAVI was measured by VS-1000 apparatus. Our results showed that CAVI was significantly higher in hypertension subjects with DM than in healthy and hypertension group, respectively (8.59 ± 1.08 vs 7.23 ± 1.10; 8.59 ± 1.08 vs 7.94 ± 1.33; both P hypertension subjects with DM compared with healthy and hypertension groups. Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  16. Trend, projection, and appropriate body mass index cut-off point for diabetes and hypertension in Bangladesh.

    Science.gov (United States)

    Rahman, Md Mizanur; Akter, Shamima; Jung, Jenny; Rahman, Md Shafiur; Sultana, Papia

    2017-04-01

    Rapid increasing of high body mass index (BMI) is a global health concern. Population with high BMI predicts an increased risk of diabetes and hypertension. The objective of the present study is to estimate the trend and prediction of diabetes and hypertension in Bangladesh, to examine the association of BMI with risk of diabetes and hypertension, and to ascertain an appropriate BMI cut-off point for screening diabetes. We searched PubMed from inception to August 2016 and identified studies reporting diabetes and hypertension prevalence in Bangladesh. Bangladesh Demographic and Health Survey 2011 data was also included in this study. Bayesian model was used to estimate trend and projection in diabetes and hypertension prevalence by sex and residence. Receiver operating characteristic curves was used to determine the optimal BMI cut-off point for screening diabetes. Of 535 articles reviewed, 35 studies reported prevalence of diabetes and hypertension. Prevalence of diabetes (95% credible interval) increased between 1992 and 2015 from 3.2% (2.2-4.3) to 12.1% (9.1-15.4) in men, and from 2.5% (1.8-3.5) to 13.4% (9.7-17.6) in women. Diabetes prevalence in 2030 is expected to reach 23.6% (13.6-36.3) for men and 33.5% (19.9-50.9) for women. Hypertension prevalence increased between 1992 and 2015 from 11.0% (8.6-13.7) to 20.4% (18.4-22.4%) in 2015 in men, and from 14.0% (10.3-19.0) to 21.3% (19.0-23.6) in women. Annual average rate of change for diabetes prevalence was higher among women and in rural areas, while for hypertension prevalence it was higher in men and urban areas. Adults with BMI of 22.5kg/m 2 or above had a higher risk of diabetes and hypertension in this study. The optimal BMI cut-off point for screening diabetes was 23kg/m 2 for overall population, 22kg/m 2 for men, and 23kg/m 2 for women. Diabetes is more prevalent among women and rural population groups, while hypertension is more prevalent among men and urban population groups in Bangladesh. A BMI of 22

  17. Serum Superoxide Dismutase Is Associated with Vascular Structure and Function in Hypertensive and Diabetic Patients

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    Manuel A. Gómez-Marcos

    2016-01-01

    Full Text Available Oxidative stress is associated with cardiac and vascular defects leading to hypertension and atherosclerosis, being superoxide dismutase (SOD one of the main intracellular antioxidant defence mechanisms. Although several parameters of vascular function and structure have a predictive value for cardiovascular morbidity-mortality in hypertensive patients, there are no studies on the involvement of SOD serum levels with these vascular parameters. Thus, we assessed if SOD serum levels are correlated with parameters of vascular function and structure and with cardiovascular risk in hypertensive and type 2 diabetic patients. We enrolled 255 consecutive hypertensive and diabetic patients and 52 nondiabetic and nonhypertensive controls. SOD levels were measured with an enzyme-linked immunosorbent assay kit. Vascular function and structure were evaluated by pulse wave velocity, augmentation index, ambulatory arterial stiffness index, and carotid intima-media thickness. We detected negative correlations between SOD and pressure wave velocity, peripheral and central augmentation index and ambulatory arterial stiffness index, pulse pressure, and plasma HDL-cholesterol, as well as positive correlations between SOD and plasma uric acid and triglycerides. Our study shows that SOD is a marker of cardiovascular alterations in hypertensive and diabetic patients, since changes in its serum levels are correlated with alterations in vascular structure and function.

  18. Diabetic nephropathy and arterial hypertension. The effect of antihypertensive treatment

    DEFF Research Database (Denmark)

    Parving, H H; Andersen, A R; Smidt, U M

    1983-01-01

    Our longitudinal study of urinary albumin excretion rate in long-term insulin-dependent diabetics without proteinuria (negative albustix) suggests that early detection of patients at high and low risk of developing persistent proteinuria, i.e., diabetic nephropathy, is possible by using a sensitive...... method for albumin determination. Our prospective studies in young insulin-dependent diabetics with diabetic nephropathy show that the rate of decline in glomerular filtration rate (GFR) varies considerably, with a mean of 0.75 ml/min/mo and a range from 0.1 to 1.50 ml/min/mo, and that an increase...

  19. Vejledning i diagnostik af type 2-diabetes. Udredning, diagnostik og glukosemåling

    DEFF Research Database (Denmark)

    Borch-Johnsen, Knut; Beck-Nielsen, Henning; Christiansen, Jens Sandahl

    2003-01-01

    World wide the prevalence of type 2 diabetes is increasing and 30-50% of patients are undiagnosed. Early detection and intervention may decrease the risk of late diabetic complications, and thus clear guidelines for early detection and diagnosis of type 2 diabetes are needed. We recommend those i...

  20. Coincidence of diabetes mellitus and hypertension in a semi-urban Cameroonian population: a cross-sectional study.

    Science.gov (United States)

    Katte, Jean-Claude; Dzudie, Anastase; Sobngwi, Eugene; Mbong, Eta N; Fetse, Gerard Tama; Kouam, Charles Kouam; Kengne, Andre-Pascal

    2014-07-08

    Hypertension and diabetes mellitus are increasingly common in population within Africa. We determined the rate of coincident diabetes and hypertension and assessed the levels of co-awareness, treatment and control in a semi-urban population in Cameroon. A total of 1702 adults (967 women) self-selected from the community were consecutively recruited in Bafoussam (West region of Cameroon) during November 2012. Existing diabetes and hypertension and treatments were investigated and blood pressure and fasting blood glucose measured. Multinomial logistic regressions models were used to investigate the determinants of prevalent diabetes and hypertension. Age-standardized prevalence rates (95% confidence intervals) men vs. women were 40.4% (34.7 to 46.1) and 23.8% (20.4 to 27.2) for hypertension alone; 3.3% (1.5 to 5.1) and 5.6% (3.5 to 7.7) for diabetes alone; and 3.9% (2.6 to 5.2) and 5.0% (3.5 to 6.5) for hypertension and diabetes. The age-standardized awareness, treatment and control rates for hypertension alone were 6.5%, 86.4% and 37.2% for men, and 24.3%, 52.1% and 51.6% in women. Equivalent figures for diabetes alone were 35.4%, 65.6% and 23.1% in men and 26.4%, 75.5% and 33.7% in women; and those for hypertension and diabetes were 86.6%, 3.3% and 0% in men, and 74.7%, 22.6% and 0% in women. Sex, age and adiposity were the main determinants of the three conditions. Coincident diabetes and hypertension is as high as diabetes alone in this population, driven by sex, age and adiposity. Awareness, treatment and control remain unacceptably low.

  1. A mixed-methods needs assessment of adult diabetes mellitus (type II) and hypertension care in Toledo, Belize.

    Science.gov (United States)

    Dekker, Annette M; Amick, Ashley E; Scholcoff, Cecilia; Doobay-Persaud, Ashti

    2017-02-28

    Non-communicable diseases, including diabetes mellitus and hypertension, continue to disproportionately burden low- and middle-income countries. However, little research has been done to establish current practices and management of chronic disease in these settings. The objective of this study was to examine current clinical management and identify potential gaps in care of patients with diabetes mellitus and hypertension in the district of Toledo, Belize. The study used a mixed methodology to assess current practices and identify gaps in diabetes mellitus and hypertension care. One hundred and twenty charts of the general clinic population were reviewed to establish disease epidemiology. One hundred and seventy-eight diabetic and hypertensive charts were reviewed to assess current practices. Twenty providers completed questionnaires regarding diabetes mellitus and hypertension management. Twenty-five individuals with diabetes mellitus and/or hypertension answered a questionnaire and in-depth interview. The prevalence of diabetes mellitus and hypertension was 12%. Approximately 51% (n = 43) of patients with hypertension were at blood pressure goal and 26% (n = 21) diabetic patients were at glycemic goal based on current guidelines. Of the patients with uncontrolled diabetes, 49% (n = 29) were on two oral agents and only 10% (n = 6) were on insulin. Providers stated that barriers to appropriate management include concerns prescribing insulin and patient health literacy. Patients demonstrated a general understanding of the concept of chronic illness, however lacked specific knowledge regarding disease processes and self-management strategies. This study provides an initial overview of diabetes mellitus and hypertension management in a diverse patient population in rural Belize. Results indicate areas for future investigation and possible intervention, including barriers to insulin use and opportunities for lifestyle-specific disease education for

  2. Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China.

    Science.gov (United States)

    Huang, Xiao-Bo; Tang, Wei-Wei; Liu, Ya; Hu, Rong; Ouyang, Ling-Yun; Liu, Jian-Xiong; Li, Xiu-Jun; Yi, Yan-Jing; Wang, Tzung-Dau; Zhao, Shui-Ping

    2017-01-01

    This study aimed to assess the prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a cross-sectional survey was conducted in 4021 hypertensive patients aged 40 to 79 years living in Chengdu and Chongqing, China. Fasting plasma glucose (FPG) and 2h plasma glucose (2-hPG) in an oral glucose-tolerance test (OGTT) were used for assessments. Whether the patients previously had diabetes (DM) was determined by their own reports. The survey was carried out by the same questionnaire for all respondents. DM prevalence was 32.0% in hypertensive patients aged 40 to 79 years in Southwest China, with the rates of 29.6% and 33.5% in men and women, respectively (Page age and body-mass index. DM prevalence rates were 16.9%, 24.7%, 38.2% and 41.9% in hypertensive patients aged 40-49, 50-59, 60-69 and over 70, respectively. DM prevalence were 30.6%, 27.9%, 37.1%, and 37.4%, for BMIaged 40 to 79 years in Southwest China. Using only fasting blood glucose testing without OGTT would have resulted in 65.0% of missed DM diagnosis in these newly diagnosed patients. The prevalence of DM and unrecognized DM were high in hypertensive patients aged 40 to 79 years in Southwest China.These findings indicate that hypertensive patients aged 40 to 79 years should regularly submit to community-based OGTT screening for timely DM diagnosis.

  3. Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: A systematic comparison of their impact on cognition

    NARCIS (Netherlands)

    van den Berg, Esther; Kloppenborg, Raoul P.; Kessels, Roy P. C.; Kappelle, L. Jaap; Biessels, Geert Jan

    2009-01-01

    Vascular risk factors, such as type 2 diabetes mellitus, hypertension, dyslipidemia and obesity, have been associated with an increased risk of cognitive dysfunction, particularly in the elderly. The aim of this systematic review was to compare these risk factors with regard to the nature and

  4. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction.

    Science.gov (United States)

    Williams, Paul T; Thompson, Paul D

    2013-05-01

    To test whether equivalent energy expenditure by moderate-intensity (eg, walking) and vigorous-intensity exercise (eg, running) provides equivalent health benefits. We used the National Runners' (n=33 060) and Walkers' (n=15 945) Health Study cohorts to examine the effect of differences in exercise mode and thereby exercise intensity on coronary heart disease (CHD) risk factors. Baseline expenditure (metabolic equivant hours per day [METh/d]) was compared with self-reported, physician-diagnosed incident hypertension, hypercholesterolemia, diabetes mellitus, and CHD during 6.2 years follow-up. Running significantly decreased the risks for incident hypertension by 4.2% (Pdiabetes mellitus by 12.1% (Phypertension; and (3) 43.5%, 44.1%, 47.7%, and 68.2% from running, and 34.1%, 44.2% and 23.6% from walking for diabetes mellitus (walking >5.4 METh/d excluded for too few cases). The risk reductions were not significantly different for running than walking for diabetes mellitus (P=0.94), hypertension (P=0.06), or CHD (P=0.26), and only marginally greater for walking than running for hypercholesterolemia (P=0.04). Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD.

  5. A Curriculum-Based Health Service Program in Hypertension, Diabetes, Venereal Diseases and Cardiopulmonary Resuscitation

    Science.gov (United States)

    Coker, Samuel T.; Janer, Ann L.

    1978-01-01

    Special screening and education courses in hypertension, diabetes, venereal disease, and cardiopulmonary resuscitation were added as electives at the Auburn University School of Pharmacy. Applied learning experiences for students and services to the community are achieved. Course goals and content and behavioral objectives in each area are…

  6. Multimorbidity and Persistent Depression among Veterans with Diabetes, Heart Disease, and Hypertension

    Science.gov (United States)

    Findley, Patricia; Shen, Chan; Sambamoorthi, Usha

    2011-01-01

    This study investigated the association between multimorbidity and persistent depression among cohorts of veterans with diabetes, heart disease, or hypertension. The retrospective longitudinal analysis used national administrative data on around 1.38 million Veteran Health Administration clinic users merged with Medicare claims data.…

  7. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study.

    NARCIS (Netherlands)

    Korf, E.S.; Straaten, E.C. van; Leeuw, F.E. de; Flier, W.M.; Barkhof, F.; Pantoni, L.; Basile, A.M.; Inzitari, D.; Erkinjuntti, T.; Wahlund, L.O.; Rostrup, E.; Schmidt, R.; Fazekas, F.; Scheltens, P.

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white

  8. Type 2 diabetes and hypertension in older adults: a case study.

    Science.gov (United States)

    Spencer, J

    The management of long-term conditions in the older adult population can be challenging and complex. After examining the literature and exploring some common issues, this article uses a reflective case study to demonstrate key findings in the management of hypertension and diabetes in an older adult that can be used to support effective interventions and positive outcomes.

  9. Antihypertensive treatment in spontaneously hypertensive rats with streptozotocin-induced diabetes mellitus.

    Science.gov (United States)

    Kusaka-Nakamura, M; Kishi, K; Miyazawa, A; Yagi, S; Sokabe, H

    1988-01-01

    Recent clinical reports have suggested that hypertension accelerates the progress of diabetic nephropathy and retinopathy, whereas antihypertensive treatments may retard them. Thus, the effect of antihypertensive treatment in diabetes mellitus with hypertension was evaluated in rats. A model of diabetes mellitus with hypertension has been developed in spontaneously hypertensive (SHR) rats by unilateral nephrectomy and streptozotocin (STZ, 30 mg/kg, i.v. treatment). The rats were treated with four antihypertensive drugs orally for 12 weeks thereafter. STZ treatment induced chronic hypeglycaemia (300-400 mg/dl), decreased body weight and heart rate, and caused vascular changes of ophthalmic fundi and cataracta. The kidney of these rats showed proliferative changes such as periarteritis nodosa, hyperplasia, or fibronecrosis of the arterioles, exudative changes, mesangial proliferation, or thickening of the basement membrane of the glomeruli. Enalapril (10 mg/kg per day) and remipril (Hoe 498) (1 mg/kg per day), converting enzyme inhibitors, or arotinolol (20 mg/kg per day), a beta-adrenoceptor blocking drug, decreased blood pressure, prevented the development of renal and ocular lesions, and tended to increase creatinine clearance. Nisoldipine (3 mg/kg per day), a calcium-entry blocking drug, tended to decrease blood glucose, and prevented the decrease of body weight and development of ocular lesions. In conclusion, antihypertensive treatments were effective in preventing the progress of diabetic retinopathy and nephropathy, and renal insufficiency in this animal model.

  10. Weight control behaviors in overweight/obese U.S. adults with diagnosed hypertension and diabetes

    Directory of Open Access Journals (Sweden)

    Li Chaoyang

    2009-03-01

    Full Text Available Abstract Background Obesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Losing weight by means of energy restriction and physical activity has been effective in preventing and managing these diseases. However, weight control behaviors among overweight/obese adults with these conditions are poorly understood. Methods Using self-reported data from 143,386 overweight/obese participants (aged ≥ 18 years in the 2003 Behavioral Risk Factor Surveillance System, we examined the proportion of overweight/obese adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status. Results Among all participants, 58% of those with hypertension, 60% of those with diabetes, and 72% of those with both diseases tried to lose weight, significantly higher than the 50% of those with neither condition (Bonferroni corrected P Conclusion The proportion of overweight/obese patients with diagnosed hypertension and/or diabetes who attempted to lose weight remains suboptimal and the weight control strategies varied significantly among these patients.

  11. Obesity, diabetes, hypertension, and vegetarian status among Seventh-Day Adventists in Barbados: preliminary results.

    Science.gov (United States)

    Brathwaite, Noel; Fraser, Henry S; Modeste, Naomi; Broome, Hedy; King, Rosaline

    2003-01-01

    A population-based sample of Seventh-Day Adventists was studied to determine the relationship between vegetarian status, body mass index (BMI), obesity, diabetes mellitus (DM), and hypertension, in order to gain a better understanding of factors influencing chronic diseases in Barbados. A systematic sampling from a random start technique was used to select participants for the study. A standard questionnaire was used to collect data on demographic and lifestyle characteristics, to record anthropometrics and blood pressure measurements, and to ascertain the hypertension and diabetes status of participants. The sample population consisted of 407 Barbadian Seventh-Day Adventists (SDAs), who ranged in age from 25 to 74 years. One hundred fifty-three (37.6%) participants were male, and 254 (62.4%) were female, and 43.5% were vegetarians. The prevalence rates of diabetes and hypertension were lower among long-term vegetarians, compared to non-vegetarians, and long-term vegetarians were, on average, leaner than non-vegetarians within the same cohort. A significant association was observed between a vegetarian diet and obesity (vegetarian by definition P=.04, self-reported vegetarian P=.009) in this population. Other components of the study population lifestyle should be further analyzed to determine the roles they may plan in lessening the prevalence rates of obesity, diabetes, and hypertension.

  12. Study of prevalence of type 2 diabetes mellitus and hypertension in overweight and obese people

    Directory of Open Access Journals (Sweden)

    Abhijit Mandal

    2014-01-01

    Full Text Available Context: In recent years, there has been a marked change in life-style of South Asian countries caused by economic growth, affluence, urbanization and dietary westernization. Few studies on the prevalence of obesity, hypertension and diabetes in the Indian population have been reported. However, there has been scarce literature on the study of prevalence of type 2 diabetes mellitus (DM and Hypertension in overweight and obese people in India with criteria suggested by World Health Organization (WHO for Asians. Information on such public health issues would provide evidence based data to develop guidelines and policies on this subject. Aim: The aim of this article is to determine the prevalence of hypertension and type 2 DM in overweight and obese people. Setting and Design: A cross-sectional study consisted of people selected from the out-patient department and indoors of a large defense hospital in a semi urban area of Assam. Materials and Methods: Patients with overweight and obesity, reporting for consultation and medical examination were taken into the study. The data collected was analyzed using the criteria for overweight, obesity, diabetes and hypertension defined by WHO, Joint National Committee VII and International Diabetes Federation, American Diabetes Association. A descriptive statistical analysis has been carried out in the study. Results: A total of 300 people were the subject population of this study. Among the subject population, there were 97 overweight and 203 obese. The 56 subjects were found to be diabetic. The prevalence of type 2 DM in overweight subjects was 15.5% and in obese was 20.2% and overall was 18.7%. Prevalence of hypertension in the overweight population was 8.2% and in obese was 22.2% and overall found to be 17.7%. Conclusions: The prevalence of type 2 DM, hypertension in the obese group of the study population were found to be 20.2%, 22.2% and in the overweight population were 15.5% and 8.2%, respectively

  13. Study of prevalence of type 2 diabetes mellitus and hypertension in overweight and obese people.

    Science.gov (United States)

    Mandal, Abhijit

    2014-01-01

    In recent years, there has been a marked change in life-style of South Asian countries caused by economic growth, affluence, urbanization and dietary westernization. Few studies on the prevalence of obesity, hypertension and diabetes in the Indian population have been reported. However, there has been scarce literature on the study of prevalence of type 2 diabetes mellitus (DM) and Hypertension in overweight and obese people in India with criteria suggested by World Health Organization (WHO) for Asians. Information on such public health issues would provide evidence based data to develop guidelines and policies on this subject. The aim of this article is to determine the prevalence of hypertension and type 2 DM in overweight and obese people. A cross-sectional study consisted of people selected from the out-patient department and indoors of a large defense hospital in a semi urban area of Assam. Patients with overweight and obesity, reporting for consultation and medical examination were taken into the study. The data collected was analyzed using the criteria for overweight, obesity, diabetes and hypertension defined by WHO, Joint National Committee VII and International Diabetes Federation, American Diabetes Association. A descriptive statistical analysis has been carried out in the study. A total of 300 people were the subject population of this study. Among the subject population, there were 97 overweight and 203 obese. The 56 subjects were found to be diabetic. The prevalence of type 2 DM in overweight subjects was 15.5% and in obese was 20.2% and overall was 18.7%. Prevalence of hypertension in the overweight population was 8.2% and in obese was 22.2% and overall found to be 17.7%. The prevalence of type 2 DM, hypertension in the obese group of the study population were found to be 20.2%, 22.2% and in the overweight population were 15.5% and 8.2%, respectively. This indicates that the prevalence of type 2 DM and hypertension increases with increasing weight of

  14. Effects of diabetes mellitus and systemic arterial hypertension on elderly patients' hearing.

    Science.gov (United States)

    Rolim, Laurie Penha; Samelli, Alessandra Giannella; Moreira, Renata Rodrigues; Matas, Carla Gentile; Santos, Itamar de Souza; Bensenor, Isabela Martins; Lotufo, Paulo Andrade

    2017-09-21

    Chronic diseases can act as an accelerating factor in the auditory system degeneration. Studies on the association between presbycusis and diabetes mellitus and systemic arterial hypertension have shown controversial conclusions. To compare the initial audiometry (A1) with a subsequent audiometry (A2) performed after a 3 to 4-year interval in a population of elderly patients with diabetes mellitus and/or systemic arterial hypertension, to verify whether hearing loss in these groups is more accelerated when compared to controls without these clinical conditions. 100 elderly individuals participated in this study. For the auditory threshold assessment, a previous complete audiological evaluation (A1) and a new audiological evaluation (A2) performed 3-4 years after the first one was utilized. The participants were divided into four groups: 20 individuals in the diabetes mellitus group, 20 individuals in the systemic arterial hypertension group, 20 individuals in the diabetes mellitus/systemic arterial hypertension group and 40 individuals in the control group, matching them with each study group, according to age and gender. ANOVA and Kruskal-Wallis statistical tests were used, with a significance level set at 0.05. When comparing the mean annual increase in the auditory thresholds of the A1 with the A2 assessment, considering each study group and its respective control, it can be observed that there was no statistically significant difference for any of the frequencies for the diabetes mellitus group; for the systemic arterial hypertension group, significant differences were observed after 4kHz. For the diabetes mellitus and systemic arterial hypertension group, significant differences were observed at the frequencies of 500, 2kHz, 3kHz and 8kHz. It was observed that the systemic arterial hypertension group showed the greatest decrease in auditory thresholds in the studied segment when compared to the other groups, suggesting that among the three studied conditions

  15. Weight control behaviors in overweight/obese U.S. adults with diagnosed hypertension and diabetes

    Science.gov (United States)

    Zhao, Guixiang; Ford, Earl S; Li, Chaoyang; Mokdad, Ali H

    2009-01-01

    Background Obesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Losing weight by means of energy restriction and physical activity has been effective in preventing and managing these diseases. However, weight control behaviors among overweight/obese adults with these conditions are poorly understood. Methods Using self-reported data from 143,386 overweight/obese participants (aged ≥ 18 years) in the 2003 Behavioral Risk Factor Surveillance System, we examined the proportion of overweight/obese adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status. Results Among all participants, 58% of those with hypertension, 60% of those with diabetes, and 72% of those with both diseases tried to lose weight, significantly higher than the 50% of those with neither condition (Bonferroni corrected P lose weight was 1.11 (95% confidence interval [CI]: 1.05–1.17) in participants with hypertension, 1.02 (95% CI: 0.90–1.15) in participants with diabetes, and 1.18 (95% CI: 1.07–1.29) in participants with both diseases (participants with neither condition as the referent). Among 78,446 participants who tried to lose weight, 23% of those with hypertension only and 28% of those with both hypertension and diabetes reported adopting a low fat/low calorie (LF/LC) diet in controlling their weight, significantly higher than 19% of those with neither disease (Bonferroni corrected P lose weight was 1.46 (95% CI: 1.15–1.84) in participants with both diseases. The AOR for adopting a LF/LC diet only to lose weight was 1.72 (95% CI: 1.35–2.20) in participants with both diseases and was 1.21 (95% CI: 1.03–1.40) in participants with hypertension only. Conclusion The proportion of overweight/obese patients with diagnosed hypertension and/or diabetes who attempted to lose weight remains suboptimal and the weight control strategies varied significantly among

  16. T-wave axis deviation and left ventricular hypertrophy interaction in diabetes and hypertension.

    Science.gov (United States)

    Assanelli, Deodato; Di Castelnuovo, Augusto; Rago, Livia; Badilini, Fabio; Vinetti, Giovanni; Gianfagna, Francesco; Salvetti, Massimo; Zito, Francesco; Donati, Maria Benedetta; de Gaetano, Giovanni; Iacoviello, Licia

    2013-01-01

    Electrocardiographic signs of left ventricular hypertrophy (ECG-LVH) and T-wave axis (TA) deviation are independent predictors of fatal and non fatal events. We assessed the prevalence of ECG-LVH, TA abnormalities and their combination according to the presence or absence of diabetes and/or hypertension in a large sample of the adult general Italian population. Data from 10,184 women (54 ± 11 years) and 8775 men (54 ± 11 years) were analyzed from the Moli-sani cohort, a database of randomly recruited adults (age >35) from the general population of Molise, a central region of Italy that includes collection of standard 12-lead resting ECG. Subjects with previous myocardial infarction, angina, cerebrovascular disease or left bundle brunch block or missing values for TA or ECG-LVH have been excluded. TA was measured from the standard 12-lead ECG and it was defined as the rotation of the T wave in the frontal plane as computed by a proprietary algorithm (CalECG/Bravo, AMPS-LLC, NY). ECG-LVH was defined as Sokolow Lyon voltage (SLv) >35 mm or Cornell voltage duration Product (CP) >= 2440 mm*ms. Among subjects with ECG-LVH, prevalence of hypertension was 59.0% and 49.7%, respectively for men and women, whereas that of diabetes was 10.7% and 5.7%. In hypertensives, TA was normal in 72.3% of subjects, borderline in 24.8% and abnormal in 2.9%. In diabetics, TA was normal in 70.4% of subjects, borderline in 26.5% and abnormal in 3.1%. In both hypertensive and diabetic subjects, the prevalence of ECG-LVH, was significantly greater in subjects with borderline or abnormal TA. Hypertension was an independent predictor of abnormal TA (odd ratio: 1.38, P = .025). These results suggest that hypertension might play a relevant role in the pathogenesis of TA deviation. © 2013.

  17. Patterns of anti-hypertensive therapy in diabetic patients with and without reduced renal function.

    Science.gov (United States)

    Sweileh, Waleed M; Sawalha, Ansam F; Zyoud, Sa'ed H; Al-Jabi, Samah W; Tameem, Eman J

    2010-07-01

    Renal function deterioration is a common complication in patients with diabetes mellitus and hypertension. Appropriate use of anti-hypertensive agents and tight control of blood pressure (BP) can minimize and delay such complications. This study was performed in order to investigate the utilization patterns of anti-hypertensive agents and to evaluate BP control among diabetic-hypertensive patients with and without reduced renal function. In a retrospective cohort study, all diabetic-hypertensive patients attending The Al-Watani Medical Governmental Center from August 01, 2006 until August 01, 2007 were enrolled in the study. Patients with congestive heart failure and/or end-stage renal disease were excluded from the study. The proportion of use of five different anti-hypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 drugs, and separately among patients with and without reduced renal function. Over 60% of patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and (beta-blockers (12.5%). The majority of patients (> 55%) were either on mono or no drug therapy. Patients on monotherapy were mostly receiving ACEI/ARB (60%). In patients with reduced renal function, use of diuretics, but not ACEI/ARB or CCB, was higher and 41.8% of the patients were on monotherapy compared to 46.6% in patients with normal renal function. The proportion of patients achieving good BP control was 20% with mono-therapy and 28% with combination therapy. Our study suggests that the pattern of anti-hypertensive therapy was generally consistent with inter-national guidelines. Areas of improvement include increasing use of ACEI/ARB and diuretics, decreasing the number of untreated patients, and increasing the proportion of patients with well controlled BP in this population.

  18. [Effect of metformin on ventricular remodeling in patients with primary hypertension and type 2 diabetes mellitus].

    Science.gov (United States)

    Wu, Yueyang; Zhao, Wei; Zhang, Youyi; Feng, Xinheng; Li, Zhaoping; Gao, Wei

    2015-11-24

    To explore the effects of metformin on left ventricular remodeling in patients with primary hypertension and type 2 diabetes mellitus, and to investigate the effects of hypertension duration and duration of drug administration on metformin's cardiac action. The clinical and echocardiographic data of 176 patients with primary hypertension and type 2 diabetes mellitus who were admitted to department of cardiology from January to December 2012 were retrospectively analyzed. The follow-up period was 6 to 24 months (the median follow-up time was 11 months). The patients were classified into two groups according to the usage of metformin: metformin group (n=84) and control group (n=92). The clinical data and echocardiography findings were evaluated both at baseline and follow-up. Subgroup analyses were used to assess the effects of hypertension duration and duration of drug medication on metfomin's action. At baseline, there was no significant difference in interventricular septum depth (IVSD), left ventricular posterior wall depth (LVPWD), and left ventricular mass index (LVMI) between the two groups. At the follow-up period, IVSD (P=0.001), LVPWD (P=0.04) and LVMI (P=0.01) were lower in metformin group. Multiple linear regression indicated that metformin had significant influence on LVPWD (P=0.02) and LVMI (P=0.04). At the follow-up period, LVMI was lower in two metformin subgroups. Additionally, LVMI was lower in the group which the patients took metformin for more than one year than that in control group (P=0.04). For patients whose hypertension duration was not shorter than 5 years, IVSD (P=0.01) and LVMI (P=0.02) were lower in metformin group at the follow-up period, compared with control group. Metformin may attenuate hypertrophy of left ventricular in patients with primary hypertension and type 2 diabetes mellitus. In patients with longer hypertension duration and longer duration of metformin use, metformin may show more obvious effects.

  19. Heat Maps of Hypertension, Diabetes Mellitus, and Smoking in the Continental United States.

    Science.gov (United States)

    Loop, Matthew Shane; Howard, George; de Los Campos, Gustavo; Al-Hamdan, Mohammad Z; Safford, Monika M; Levitan, Emily B; McClure, Leslie A

    2017-01-01

    Geographic variations in cardiovascular mortality are substantial, but descriptions of geographic variations in major cardiovascular risk factors have relied on data aggregated to counties. Herein, we provide the first description of geographic variation in the prevalence of hypertension, diabetes mellitus, and smoking within and across US counties. We conducted a cross-sectional analysis of baseline risk factor measurements and latitude/longitude of participant residence collected from 2003 to 2007 in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Of the 30 239 participants, all risk factor measurements and location data were available for 28 887 (96%). The mean (±SD) age of these participants was 64.8(±9.4) years; 41% were black; 55% were female; 59% were hypertensive; 22% were diabetic; and 15% were current smokers. In logistic regression models stratified by race, the median(range) predicted prevalence of the risk factors were as follows: for hypertension, 49% (45%-58%) among whites and 72% (68%-78%) among blacks; for diabetes mellitus, 14% (10%-20%) among whites and 31% (28%-41%) among blacks; and for current smoking, 12% (7%-16%) among whites and 18% (11%-22%) among blacks. Hypertension was most prevalent in the central Southeast among whites, but in the west Southeast among blacks. Diabetes mellitus was most prevalent in the west and central Southeast among whites but in south Florida among blacks. Current smoking was most prevalent in the west Southeast and Midwest among whites and in the north among blacks. Geographic disparities in prevalent hypertension, diabetes mellitus, and smoking exist within states and within counties in the continental United States, and the patterns differ by race. © 2017 American Heart Association, Inc.

  20. Hypertension and Diabetes Mellitus: A Preliminary South African Health Promotion Activity Using Service-Learning Principles.

    Science.gov (United States)

    Srinivas, Sunitha C; Paphitis, Sharli Anne

    2016-06-01

    A marked increase in the chronic non-communicable diseases such as hypertension and diabetes mellitus in the South African population is in concert with global trends. A health promotion activity carried out by pharmacy students for school learners during the Sasol National Festival of Science and Technology (SciFest) in South Africa was used as a service-learning opportunity. Pilot tested quizzes on hypertension and diabetes were used to determine the level of knowledge of attendees before and after taking the computer based quiz. Posters, information leaflets and interactive models on these two conditions were also used to reach out to the larger population. Of the 203 participants for the hypertension quiz, 169 completed both the pre- and post-intervention quizzes. Similarly, 86 of the 104 participants for the diabetes quiz, completed both the pre- and post-intervention quizzes. The results show that the post-intervention quiz resulted in a significant increase in the scores from 78.2 to 85.6 % in the case of Hypertension while a marginal increase from 94.2 to 95.5 % was obtained in the case of diabetes. The knowledge of the SciFest attendees with regard to both conditions is above average and improved further after the educational intervention. Health promotion activities which include interactive educational methods and culturally appropriate materials carried out by pharmacy students during service-learning courses are important for improving the awareness on the prevention of these chronic health conditions. Heath promotion service-learning courses can assist in addressing the health care gaps which arise because of a lack of co-ordinated efforts between NGO's and local Government to address the prevention and management of non-communicable diseases such as hypertension and diabetes mellitus.

  1. Food sources of sodium, saturated fat and added sugar in the Spanish hypertensive and diabetic population.

    Science.gov (United States)

    Guallar-Castillón, Pilar; Muñoz-Pareja, Maritza; Aguilera, Ma Teresa; León-Muñoz, Luz María; Rodríguez-Artalejo, Fernando

    2013-07-01

    Previous research has shown that the diet of hypertensive and diabetic patients has a low accordance with the main nutritional recommendations, mostly due to the high intake of sodium, saturated fat and added sugars. This is the first study to identify the main food sources of these nutrients in these patients. Cross-sectional study conducted in 2008-2010 in a representative sample of the Spanish adult population, including 2323 patients with hypertension and 635 with diabetes. The habitual diet was assessed using a validated diet history. The intake of sodium, saturated fat and added sugars was estimated with Spanish food composition tables. The hypertensive and diabetic population showed, respectively, an intake of 2.9 and 3.1 g/day of sodium, 26 and 26 g/day of saturated fat, and 33 and 24 g/day of added sugar. In hypertensive and diabetic patients, respectively, most sodium intake came from bread (35%, 34%), raw-cured sausages (15%, 15%), cooked sausages (6%, 7%), and soup (5%, 6%). The main sources of saturated fat were cured cheese (13%, 13%), bakery products (12%, 11%), red meat (10%, 11%), raw-cured sausages (8%, 9%) and whole milk (4%, 4%). The food groups that most contributed to added sugar intake were sugar directly added to coffee and other beverages (27%, 19%), bakery products (15%, 19%), sugary soft drinks (10%, 13%), and whole yogurt (9%, 12%). The main food sources of nutrients were similar in all sex and age groups. In patients with hypertension and diabetes, the intake of sodium, saturated fat and added sugar can be substantially reduced by prioritizing low-salt varieties of bread, reducing the consumption of bakery products and sausages, replacing cured cheese and other whole dairy products by low-fat products, using non-sugary sweeteners, and substituting sugar-free soft drinks, or plain water, for sugary sodas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Cost-effectiveness of aliskiren in type 2 diabetes, hypertension, and albuminuria

    DEFF Research Database (Denmark)

    Delea, Thomas E; Sofrygin, Oleg; Palmer, James L

    2009-01-01

    The Aliskiren in the Evaluation of Proteinuria in Diabetes (AVOID) trial demonstrated that adding aliskiren, an oral direct renin inhibitor, at a dosage of 300 mg/d to the highest approved dosage of losartan and optimal antihypertensive therapy reduces albuminuria over 6 mo among patients with type...... 2 diabetes, hypertension, and albuminuria. The cost-effectiveness of this therapy, however, is unknown. Here, we used a Markov model to project progression to ESRD, life years, quality-adjusted life years, and lifetime costs for aliskiren plus losartan versus losartan. We used data from the AVOID...... aliskiren to losartan and optimal therapy in patients with type 2 diabetes, hypertension, and albuminuria may be cost-effective from a US health care system perspective....

  3. PGE2, Kidney Disease, and Cardiovascular Risk: Beyond Hypertension and Diabetes

    Science.gov (United States)

    Nasrallah, Rania; Hassouneh, Ramzi

    2016-01-01

    An important measure of cardiovascular health is obtained by evaluating the global cardiovascular risk, which comprises a number of factors, including hypertension and type 2 diabetes, the leading causes of illness and death in the world, as well as the metabolic syndrome. Altered immunity, inflammation, and oxidative stress underlie many of the changes associated with cardiovascular disease, diabetes, and the metabolic syndrome, and recent efforts have begun to elucidate the contribution of PGE2 in these events. This review summarizes the role of PGE2 in kidney disease outcomes that accelerate cardiovascular disease, highlights the role of cyclooxygenase-2/microsomal PGE synthase 1/PGE2 signaling in hypertension and diabetes, and outlines the contribution of PGE2 to other aspects of the metabolic syndrome, particularly abdominal adiposity, dyslipidemia, and atherogenesis. A clearer understanding of the role of PGE2 could lead to new avenues to improve therapeutic options and disease management strategies. PMID:26319242

  4. Organization of primary health care for diabetes and hypertension in high, low and middle income countries.

    Science.gov (United States)

    Lall, Dorothy; Prabhakaran, Dorairaj

    2014-08-01

    Chronic non-communicable diseases, predominantly diabetes and cardiovascular disease are a major public health problem globally. The chronicity of these diseases necessitates a restructuring of healthcare to address the multidisciplinary, sustained care including psychosocial support and development of self-management skills. Primary healthcare with elements of the chronic-care model provides the best opportunity for engagement with the health system. In this review, the authors discuss aspects of primary healthcare for management of diabetes and hypertension and innovations such as mobile-phone messaging, web-based registries, computer-based decision support systems and multifaceted health professionals in the care team among others that are being tested to improve the quality of care for these diseases in high, middle and low-income countries. The goal of quality care for diabetes and hypertension demands innovation within the realities of health systems both in high as well as low and middle-income countries.

  5. Autoregulation of glomerular filtration rate during spironolactone treatment in hypertensive patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Schjoedt, Katrine J; Christensen, Per K; Jorsal, Anders

    2009-01-01

    if spironolactone affects the ability to autoregulate GFR. METHODS: Sixteen hypertensive type 1 diabetic patients with persistent normoalbuminuria (presumed normal autoregulation) completed this randomized, double-masked, crossover trial. After a 4-week wash-out period, patients received spironolactone 25 mg o...... correlated with diabetes duration (R = 0.67, P 1c or to changes in BP. CONCLUSION: Spironolactone did not change the overall ability to autoregulate GFR in 16 hypertensive type 1 diabetic patients with normoalbuminuria. Our data...... was 115 (5) ml/min/1.73 m(2) and the BP was 146 (4)/81 (2) mmHg corresponding to a MAP of 103 (2) mmHg. Spironolactone did not significantly reduce GFR or BP. Injection of clonidine induced a significant reduction in the MAP of 17 (2) and 19 (1) mmHg during placebo and spironolactone treatment...

  6. Cerebral white matter and retinal arterial health in hypertension and type 2 diabetes mellitus.

    Science.gov (United States)

    Yau, P L; Hempel, R; Tirsi, A; Convit, A

    2013-01-01

    We examined 33 hypertensive (22 with comorbid type 2 diabetes mellitus (T2DM)) and 29 normotensive (8 with T2DM) middle-aged and elderly adults, comparable in age and education. Relative to normotensive participants, those with hypertension, in addition to a higher prevalence of periventricular white matter (WM) lesions, had significantly lower WM microstructural integrity of major fiber tracts as seen with MRI-based diffusion tensor imaging. Among participants with hypertension, those with co-morbid T2DM (n = 22) had more widespread WM pathology than those without T2DM (n = 11). Furthermore and consistent with previous research, both hypertension and T2DM were related to decreased retinal arterial diameter. Further exploratory analysis demonstrated that the observed retinal arteriolar narrowing among individual with hypertension was associated with widespread subclinical losses in WM microstructural integrity and these associations were present predominantly in the frontal lobe. We found that T2DM adds to the damaging effects of hypertension on cerebral WM, and notably these effects were independent of age and body mass index. Given that the decrease in retinal arteriolar diameter may be a biomarker for parallel pathology in cerebral arterioles, our data suggest that the frontal lobe may be particularly vulnerable to microvascular damage in the presence of hypertension and T2DM.

  7. Cerebral White Matter and Retinal Arterial Health in Hypertension and Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    P. L. Yau

    2013-01-01

    Full Text Available We examined 33 hypertensive (22 with comorbid type 2 diabetes mellitus (T2DM and 29 normotensive (8 with T2DM middle-aged and elderly adults, comparable in age and education. Relative to normotensive participants, those with hypertension, in addition to a higher prevalence of periventricular white matter (WM lesions, had significantly lower WM microstructural integrity of major fiber tracts as seen with MRI-based diffusion tensor imaging. Among participants with hypertension, those with co-morbid T2DM (n=22 had more widespread WM pathology than those without T2DM (n=11. Furthermore and consistent with previous research, both hypertension and T2DM were related to decreased retinal arterial diameter. Further exploratory analysis demonstrated that the observed retinal arteriolar narrowing among individual with hypertension was associated with widespread subclinical losses in WM microstructural integrity and these associations were present predominantly in the frontal lobe. We found that T2DM adds to the damaging effects of hypertension on cerebral WM, and notably these effects were independent of age and body mass index. Given that the decrease in retinal arteriolar diameter may be a biomarker for parallel pathology in cerebral arterioles, our data suggest that the frontal lobe may be particularly vulnerable to microvascular damage in the presence of hypertension and T2DM.

  8. Prevalence of self-reported hypertension and diabetes and ...

    African Journals Online (AJOL)

    ... factors associated with self-reported hypertension and DM. Results: Significant alcohol consumption was present in 77 (8.7%) while 26 (2.5%) were current cigarette smokers. Two hundred and seventy nine (31.5%) engaged in moderate intensity exercises like brisk walking and cycling for 10 minutes on a regular basis.

  9. Independent Relationship of Osteocalcin Circulating Levels with Obesity, Type 2 Diabetes, Hypertension, and HDL Cholesterol.

    Science.gov (United States)

    De Pergola, Giovanni; Triggiani, Vincenzo; Bartolomeo, Nicola; Nardecchia, Adele; Giagulli, Vito Angelo; Bruno, Irene; Caccavo, Domenico; Silvestris, Franco

    2016-01-01

    Osteocalcin, a protein synthesized by osteoblasts during the bone formation phase of bone remodeling, is used as a biomarker for the bone production process, and its serum levels are positively correlated with bone mineral density during treatment with anabolic bone drugs for osteoporosis. Higher fat mass has been shown to be a risk factor for osteoporosis and fragility fractures and body fat and bone interplay through several adipokines and bone-derived molecules, regulating bone remodeling, adipogenesis, body weight control, and glucose homeostasis. The aim of this study was to evaluate the relationship between total osteocalcin levels and obesity, hypertension and type 2 diabetes. The present study was performed in a cohort of 298 patients including a) 121 overweight and obese patients, unaffected by hypertension or type 2 diabetes, b) 129 subjects affected by hypertension and not by type 2 diabetes, and c) 48 subjects affected by both hypertension and type 2 diabetes. No subject of the group of overweight and obese patients was taking any kind of drug. All patients affected by hypertension, with or without type 2 diabetes, were taking drugs for hypertension. Examining only patients affected by type 2 diabetes (n: 48), 43 (90% of all) were taking drugs to reduce blood glucose levels, 26 (54% of all) were taking drugs to reduce cholesterol levels (statins and/or ezetimide, etc), and 4 (8% of all) were taking ω-3 for hypertriglyceridemia. Each patient was evaluated for anthropometric measurements as well as for serum osteocalcin and uric acid, and plasma glucose, HbA1c, and lipid determination. Osteocalcin levels were significantly and negatively associated with BMI, waist circumference, and HbA1c, and significantly and positively correlated with HDL-cholesterol and systolic blood pressure in the whole population. Osteocalcin levels did maintain an independent negative association with BMI, and HbA1c, and positive association with HDL cholesterol and systolic

  10. Delayed diagnosis of hypertension in diabetic patients monitored in primary care.

    Science.gov (United States)

    de Burgos-Lunar, Carmen; del Cura-González, Isabel; Salinero-Fort, Miguel A; Gómez-Campelo, Paloma; Pérez de Isla, Leopoldo; Jiménez-García, Rodrigo

    2013-09-01

    Delayed diagnosis of hypertension may result in inadequate blood pressure control and increased cardiovascular risk. The aim of this study was to estimate the delay in hypertension diagnosis in patients with type 2 diabetes and the likelihood of a diagnosis within a suitable period (first 6 months), and to analyze the patient and physician characteristics associated with delayed diagnosis. Retrospective dynamic cohort study, with a 7-year follow-up in primary care, of 8074 adult patients with diabetes who met the diagnostic criteria for hypertension. Two thresholds were considered: 140/90mmHg and 130/80mmHg. The time elapsed between meeting these criteria and recording the diagnosis was estimated; the time course of the likelihood of a missed diagnosis and the variables associated with correct diagnosis were assessed by Kaplan-Meier survival analysis and logistic regression analysis, respectively. The mean diagnostic delay was 8.9 (15.4) months in patients with blood pressure≥140/90mmHg compared to 15.2 (19.6) months for those with hypertension among diabetic patients was greater than 6 months and varied according to the diagnostic threshold used. Patients with baseline blood pressure≥140/90mmHg were more likely to receive a timely diagnosis. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  11. Baroreflex sensitivity in children and adolescents: physiology, hypertension, obesity, diabetes mellitus.

    Science.gov (United States)

    Honzíková, N; Závodná, E

    2016-12-13

    The increased prevalence of obesity in children and its complications have led to a greater interest in studying baroreflex sensitivity (BRS) in children. This review of BRS in children and adolescents includes subtopics on: 1. Resting values of BRS and their reproducibility, 2. Genetics of BRS, 3. The role of a primarily low BRS and obesity in the development of hypertension, and 4. Association of diabetes mellitus, BRS, and obesity. The conclusions specific to this age follow from this review: 1. The mean heart rate (HR) influences the measurement of BRS. Since the mean HR decreases during adolescence, HR should be taken into account. 2. A genetic dependency of BRS was found. 3. Low BRS values may precede pathological blood-pressure elevation in children with white-coat hypertension. We hypothesize that low BRS plays an active role in the emergence of hypertension in youth. A contribution of obesity to the development of hypertension was also found. We hypothesize that both factors, a primarily low BRS and obesity, are partially independent risk factors for hypertension in youths. 4. In diabetics, a low BRS compared to healthy children can be associated with insulin resistance. A reversibility of the BRS values could be possible after weight loss.

  12. Synergistic Interaction of Hypertension and Diabetes in Promoting Kidney Injury and the Role of Endoplasmic Reticulum Stress.

    Science.gov (United States)

    Wang, Zhen; do Carmo, Jussara M; Aberdein, Nicola; Zhou, Xinchun; Williams, Jan M; da Silva, Alexandre A; Hall, John E

    2017-05-01

    Diabetes mellitus and hypertension are major risk factors for chronic kidney injury, together accounting for >70% of end-stage renal disease. In this study, we assessed interactions of hypertension and diabetes mellitus in causing kidney dysfunction and injury and the role of endoplasmic reticulum (ER) stress. Hypertension was induced by aorta constriction (AC) between the renal arteries in 6-month-old male Goto-Kakizaki (GK) type 2 diabetic and control Wistar rats. Fasting plasma glucose averaged 162±11 and 87±2 mg/dL in GK and Wistar rats, respectively. AC produced hypertension in the right kidney (above AC) and near normal blood pressure in the left kidney (below AC), with both kidneys exposed to the same levels of glucose, circulating hormones, and neural influences. After 8 weeks of AC, blood pressure above the AC (and in the right kidney) increased from 109±1 to 152±5 mm Hg in GK rats and from 106±4 to 141±5 mm Hg in Wistar rats. The diabetic-hypertensive right kidneys in GK-AC rats had much greater increases in albumin excretion and histological injury compared with left kidneys (diabetes mellitus only) of GK rats or right kidneys (hypertension only) of Wistar-AC rats. Marked increases in ER stress and oxidative stress indicators were observed in diabetic-hypertensive kidneys of GK-AC rats. Inhibition of ER stress with tauroursodeoxycholic acid for 6 weeks reduced blood pressure (135±4 versus 151±4 mm Hg), albumin excretion, ER and oxidative stress, and glomerular injury, while increasing glomerular filtration rate in hypertensive-diabetic kidneys. These results suggest that diabetes mellitus and hypertension interact synergistically to promote kidney dysfunction and injury via ER stress. © 2017 American Heart Association, Inc.

  13. Professionals' perception of circuits of care for hypertensive or diabetic patients between primary and secondary care.

    Science.gov (United States)

    Alonso-Moreno, Francisco Javier; Martell-Claros, Nieves; de la Figuera, Mariano; Escalada, Javier; Rodríguez, Marta; Orera, Luisa

    2016-01-01

    To determine the flow of care for patients with type 2 diabetes mellitus (T2DM) and hypertension between primary care (PC) and specialized care (SC) in clinical practice, and the criteria used for referral and follow-up within the Spanish National Health System (NHS). A descriptive, cross-sectional, multicenter study. A probability convenience sampling stratified by number of physicians participating in each Spanish autonomous community was performed. Nine hundred and ninety-nine physicians were surveyed, of whom 78.1% (n=780) were primary care physicians (PCPs), while 11.9% (n=119) and 10.0% (n=100) respectively were specialists in hypertension and diabetes. KEY MEASUREMENTS: was conducted using two self administered online surveys. A majority of PCPs (63.7% and 55.5%) and specialists (79.8% and 45.0%) reported the lack of a protocol to coordinate the primary and specialized settings for both hypertension and T2DM respectively. The most widely used method for communication between specialists was the referral sheet (94.6% in PC and 92.4% in SC). The main reasons for referral to a specialist were refractory hypertension (80.9%) and suspected secondary hypertension (75.6%) in hypertensive patients, and suspicion of a specific diabetes (71.9%) and pregnancy (71.7%) in T2DM patients. Although results showed some common characteristics between PCPs and specialists in disease management procedures, the main finding was a poor coordination between PC and SC. Copyright © 2015. Published by Elsevier España, S.L.U.

  14. Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care

    Directory of Open Access Journals (Sweden)

    Abánades-Herranz Juan C

    2011-10-01

    Full Text Available Abstract Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index, were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (κ = 0.990, with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (κ = 0.778, the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who

  15. Prevalence and risk factors of hypertension and diabetes in the Katkari tribe of coastal Maharashtra

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    M G Deo

    2017-01-01

    Full Text Available Background and Objectives: Urban and rural India are both going through health epidemiological transition and will soon face huge burden of noncommunicable diseases (NCDs. Information on the status of NCDs in tribals is limited. Although the prevalence of hypertension in scheduled tribes (STs has been studied in several states by the National Nutrition Monitoring Bureau, tribe-specific data are very scanty. The objective of this study was to generate data on the status of hypertension and diabetes, the two objectively measurable NCDs in Katkaris, the dominant ST in the Raigad district of coastal Maharashtra. Methods: The study was conducted in 410 adult Katkaris (women 219 of both sexes of ≥18 years of age in three adjoining tehsils of the district. Using the Institution Review Board approved protocol; information was obtained on sociodemographic parameters, educational level, dietary pattern, and substance abuse. Prevalence of overweight, hypertension, and diabetes was measured using standard field-based procedures and techniques. Results: Katkaris, who are mostly landless manual laborers, subsist on a protein-poor, imbalanced diet. About half of women and one-third of men have body mass index (BMI <18.5 kg/m2, an indication of undernutrition. On the other hand, about 2% of participants were obese (BMI ≥30 kg/m2. The overall prevalence of hypertension and diabetes was 16.8% and 7.3%, respectively. Hypercholesterolemia was recorded in about 3% of the participants. Interpretation and Conclusions: Prevalence of diabetes and hypertension in Katkaris is still lower than that of urban and rural populations, closer to the latter. This may be due to the absence of known risk factors such as obesity, sedentary lifestyle, and hyperlipidemia in this community. Fast acculturation of the STs suggests that NCDs will soon become a major health issue in them too. It is time to launch a multicentric national study to gather baseline information on the

  16. Increased oxidative stress in obesity: implications for metabolic syndrome, diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer.

    Science.gov (United States)

    Matsuda, Morihiro; Shimomura, Iichiro

    2013-01-01

    Obesity, especially of the abdominal type, is a health problem that constitutes metabolic syndrome and increases the incidence of various diseases, including diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Various mechanisms linking obesity to these associated diseases have been postulated. One candidate is oxidative stress, which has been implicated in vascular complications of diabetes and in pancreatic -cell failure in diabetes. Notably, obese people without diabetes also display elevated levels of systemic oxidative stress. In addition, levels of oxidative stress are increased in the adipose tissue in obese mice. Treating obese mice with antioxidant agents attenuates the development of diabetes. In 3T3-L1 adipocytes, increases in reactive oxygen species (ROS) occur with lipid accumulation; the addition of free fatty acids elevates ROS generation further. Thus, adipose tissue represents an important source of ROS; ROS may contribute to the development of obesity-associated insulin resistance and type 2 diabetes. Moreover, the levels of oxidative stress present in several other types of cells or tis-sues, including those in the brain, arterial walls, and tumors, have been implicated in the pathogenesis associated with hypertension, atherosclerosis, and cancer. The increased levels of systemic oxidative stress that occur in obesity may contribute to the obesity-associated development of these diseases. © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  17. Therapeutic Target Achievement in Type 2 Diabetic Patients after Hyperglycemia, Hypertension, Dyslipidemia Management

    Directory of Open Access Journals (Sweden)

    Ah Young Kang

    2011-06-01

    Full Text Available BackgroundOur study group established "3H care" in 2002. The meaning of "3H care" attain and maintain adequate controls over hypertension, hyperlipidemia, and hyperglycemia in type 2 diabetic patients. This study evaluated the achievement of target goals after one year or more of "3H care" by specialists in our diabetic clinic.MethodsThis was a retrospective study of 200 type 2 diabetic patients who received "3H care" for one year or more in our diabetic clinic. We evaluated achievement of target goals for metabolic controls as suggested by the American Diabetes Association.ResultsOverall, 200 type 2 diabetes patients were enrolled, of whom 106 were males (53% and 94 were females (47%. After one year of "3H care," the mean HbA1c was 7.2±1.5% and the percentage of patients achieving glycemic control (HbA1c <7% was 51.8%. However only 32.2% of hypertensive patients achieved the recommended target. After one year of "3H care," the percentages of those who achieved the target value for dyslipidemia were 80.0% for total cholesterol, 66.3% for low density lipoprotein cholesterol, 57.9% for triglyceride, and 51.8% for high density lipoprotein cholesterol. The percentage that achieved all three targets level was only 4.4% after one year and 14.8% after two years.ConclusionThe results of this study demonstrate that only a minor proportion of patients with type 2 diabetes achieved the recommended goals despite the implementation of "3H care." It is our suggestion that better treatment strategies and methods should be used to control hypertension, hyperlipidemia and hyperglycemia.

  18. Hypertension increases urinary excretion of immunoglobulin G, ceruloplasmin and transferrin in normoalbuminuric patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Ohara, Nobumasa; Hanyu, Osamu; Hirayama, Satoshi; Nakagawa, Osamu; Aizawa, Yoshifusa; Ito, Seiki; Sone, Hirohito

    2014-02-01

    Increased urinary excretion of certain plasma proteins, such as immunoglobulin G (IgG), ceruloplasmin and transferrin, with different molecular radii of 55 Å or less and different isoelectric points have been reported to precede development of microalbuminuria in patients who have diabetes mellitus with hypertension. We examined how hypertension affects these urinary proteins in a diabetic state. Excretion of IgG, ceruloplasmin, transferrin, albumin, α2-macroglobulin with a large molecular radius of 88 Å and N-acetylglucosaminidase in first-morning urine samples were measured in normoalbuminuric patients (urinary albumin-to-creatinine ratio hypertension and nondiabetes mellitus (group hypertension, n = 32), type 2 diabetes mellitus and normotension (group diabetes mellitus, n = 52) and type 2 diabetes mellitus and hypertension (group Both, n =45), and in age-matched controls (n = 72). Urinary IgG, ceruloplasmin, transferrin, albumin and N-acetylglucosaminidase and estimated glomerular filtration rate (eGFR) were significantly elevated in groups diabetes mellitus and Both compared with controls. Furthermore, urinary IgG, ceruloplasmin and transferrin in group Both were significantly higher than those in group diabetes mellitus. These exhibited a positive and relatively strong association with eGFR compared with controls. No significant difference in urinary albumin or N-acetylglucosaminidase was found between the two diabetic groups. In contrast, group hypertension had elevated urinary transferrin without any changes in the other compounds. Urinary α2-macroglobulin did not differ among the four groups. These findings suggest that normoalbuminuric diabetic patients without hypertension have both glomerular hemodynamic changes such as increased intraglomerular hydraulic pressure and altered proximal tubules, and that hypertension increases intraglomerular hydraulic pressure. Increased urinary IgG, ceruloplasmin and transferrin may reflect an increase in

  19. Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Zengfang; Wang, Zengyan; Wang, Luang; Qiu, Mingyue; Wang, Yangang; Hou, Xu; Guo, Zhong; Wang, Bin

    2017-03-01

    Many studies assessed the association between hypertensive disorders during pregnancy and risk of type 2 diabetes mellitus in later life, but contradictory findings were reported. A systemic review and meta-analysis was carried out to elucidate type 2 diabetes mellitus risk in women with hypertensive disorders during pregnancy. Pubmed, Embase, and Web of Science were searched for cohort or case-control studies on the association between hypertensive disorders during pregnancy and subsequent type 2 diabetes mellitus. Random-effect model was used to pool risk estimates. Bayesian meta-analysis was carried out to further estimate the type 2 diabetes mellitus risk associated with hypertensive disorders during pregnancy. Seventeen cohort or prospective matched case-control studies were finally included. Those 17 studies involved 2,984,634 women and 46,732 type 2 diabetes mellitus cases. Overall, hypertensive disorders during pregnancy were significantly correlated with type 2 diabetes mellitus risk (relative risk = 1.56, 95 % confidence interval 1.21-2.01, P = 0.001). Preeclampsia was significantly and independently correlated with type 2 diabetes mellitus risk (relative risk = 2.25, 95 % confidence interval 1.73-2.90, P risk (relative risk = 2.06, 95 % confidence interval 1.57-2.69, P analysis showed the relative risks of type 2 diabetes mellitus risk for individuals with hypertensive disorders during pregnancy, preeclampsia, and gestational hypertension were 1.59 (95 % credibility interval: 1.11-2.32), 2.27 (95 % credibility interval: 1.67-2.97), and 2.06 (95 % credibility interval: 1.41-2.84), respectively. Publication bias was not evident in the meta-analysis. Preeclampsia and gestational hypertension are independently associated with substantially elevated risk of type 2 diabetes mellitus in later life.

  20. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    DEFF Research Database (Denmark)

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E

    2007-01-01

    was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95......HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...

  1. Validation of behaviour measurement instrument of patients with diabetes mellitus and hypertension

    Science.gov (United States)

    Saputri, G. Z.; Akrom; Dini, S. M.

    2017-11-01

    Non-adherence to the treatment of chronic diseases such as hypertension and Diabetes Mellitus (DM) is a major obstacle in achieving patient therapy targets and quality of life of patients. A comprehensive approach involving pharmacists counselling has shown influences on changes in health behaviour and patient compliance. Behaviour changes in patients are one of the parameters to assess the effectiveness of counselling and education by pharmacists. Therefore, it is necessary to develop questionnaires of behaviour change measurement in DM-hypertension patients. This study aims to develop a measurement instrument in the form of questionnaires in assessing the behaviour change of DM-hypertension patients. Preparation of question items from the questionnaire research instrument refers to some guidelines and previous research references. Test of questionnaire instrument valid was done with expert validation, followed by pilot testing on 10 healthy respondents, and 10 DM-hypertension patients included in the inclusion criteria. Furthermore, field validation test was conducted on 37 patients who had undergone outpatient care at the PKU Muhammadiyah Yogyakarta City Hospital and The Gading Clinic in Yogyakarta. The inclusion criteria were male and female patients, aged 18-65, diagnosed with type 2 diabetes with hypertension who received oral antidiabetic drugs and antihypertensives, and who were not illiterate and co-operative. The data were collected by questionnaire interviews by a standardized pharmacist. The result of validation test using Person correlation shows the value of 0.33. The results of the questionnaire validation test on 37 patients showed 5 items of invalid questions with the value of r 0.33. The reliability value is shown from the Cronbach's alpha value of 0.722 (> 0.6), implying that the questionnaire is reliable for DM-hypertension patients. This Behavioural change questionnaire can be used on DM-hypertension patients, and an FGD approach is required

  2. Allicin, a SUR2 opener: possible mechanism for the treatment of diabetic hypertension in rats

    Directory of Open Access Journals (Sweden)

    Harikesh Dubey

    2012-04-01

    Full Text Available The garlic (Allium sativum L., Amaryllidaceae has been popularly used in the treatment of diabetes and cardiac complications. In the present work, we have studied the possible mechanisms, sulfonylurea receptor (SUR selectivity of allicin in diabetic hypertensive rats. Diabetic hypertension was induced by intraperitoneal injection of streptozotocin (50 mg/kg followed by daily administration of dexamethasone (10 µg/kg, s.c.. Different parameters, blood pressure and blood glucose levels were studied in the rats weekly up to eight weeks. Allicin (8 mg/kg, p.o. shows potent antidiabetic (*p<0.001 as well as antihypertensive effect (**p<0.001, *p<0.01. It may act as a vasodilator by hyperpolarizing the membrane of normal vascular smooth muscle cells. The hyperpolarization in vascular smooth muscle occurs due to K+ channel opener activity. Antihypertensive effect of allicin is inhibited by glibenclamide, nonselective SUR blocker while combination of allicin with nateglinide, selective SUR1 blocker exerted synergistic antihypertensive effect. The results indicates that allicin is effective in the treatment of diabetic hypertension; through a mechanism that might involve selective opening of SUR2.

  3. Allicin, a SUR2 opener: possible mechanism for the treatment of diabetic hypertension in rats

    Directory of Open Access Journals (Sweden)

    Harikesh Dubey

    2012-10-01

    Full Text Available The garlic (Allium sativum L., Amaryllidaceae has been popularly used in the treatment of diabetes and cardiac complications. In the present work, we have studied the possible mechanisms, sulfonylurea receptor (SUR selectivity of allicin in diabetic hypertensive rats. Diabetic hypertension was induced by intraperitoneal injection of streptozotocin (50 mg/kg followed by daily administration of dexamethasone (10 µg/kg, s.c.. Different parameters, blood pressure and blood glucose levels were studied in the rats weekly up to eight weeks. Allicin (8 mg/kg, p.o. shows potent antidiabetic (*p<0.001 as well as antihypertensive effect (**p<0.001, *p<0.01. It may act as a vasodilator by hyperpolarizing the membrane of normal vascular smooth muscle cells. The hyperpolarization in vascular smooth muscle occurs due to K+ channel opener activity. Antihypertensive effect of allicin is inhibited by glibenclamide, nonselective SUR blocker while combination of allicin with nateglinide, selective SUR1 blocker exerted synergistic antihypertensive effect. The results indicates that allicin is effective in the treatment of diabetic hypertension; through a mechanism that might involve selective opening of SUR2.

  4. Identifying gaps in the continuum of care for hypertension and diabetes in two Indian communities.

    Science.gov (United States)

    Gabert, Rose; Ng, Marie; Sogarwal, Ruchi; Bryant, Miranda; Deepu, R V; McNellan, Claire R; Mehra, Sunil; Phillips, Bryan; Reitsma, Marissa; Thomson, Blake; Wilson, Shelley; Wollum, Alexandra; Gakidou, Emmanuela; Duber, Herbert C

    2017-12-27

    Non-communicable diseases (NCDs) represent the largest, and fastest growing, burden of disease in India. This study aimed to quantify levels of diagnosis, treatment, and control among hypertensive and diabetic patients, and to describe demand- and supply-side barriers to hypertension and diabetes diagnosis and care in two Indian districts, Shimla and Udaipur. We conducted household and health facility surveys, as well as qualitative focus group discussions and interviews. The household survey randomly sampled individuals aged 15 and above in rural and urban areas in both districts. The survey included questions on NCD knowledge, history, and risk factors. Blood pressure, weight, height, and blood glucose measurements were obtained. The health facility survey was administered in 48 health care facilities, focusing on NCD diagnosis and treatment capacity, including staffing, equipment, and pharmaceuticals. Qualitative data was collected through semi-structured key informant interviews with health professionals and public health officials, as well as focus groups with patients and community members. Among 7181 individuals, 32% either reported a history of hypertension or were found to have a systolic blood pressure ≥ 140 mmHg and/or diastolic ≥90 mmHg. Only 26% of those found to have elevated blood pressure reported a prior diagnosis, and just 42% of individuals with a prior diagnosis of hypertension were found to be normotensive. A history of diabetes or an elevated blood sugar (Random blood glucose (RBG) ≥200 mg/dl or fasting blood glucose (FBG) ≥126 mg/dl) was noted in 7% of the population. Among those with an elevated RBG/FBG, 59% had previously received a diagnosis of diabetes. Only 60% of diabetics on treatment were measured with a RBG demand for NCD services.

  5. The burden of hypertension, diabetes mellitus, and cardiovascular risk factors among adult Malawians in HIV care: consequences for integrated services.

    Science.gov (United States)

    Divala, Oscar H; Amberbir, Alemayehu; Ismail, Zahra; Beyene, Teferi; Garone, Daniela; Pfaff, Colin; Singano, Victor; Akello, Harriet; Joshua, Martias; Nyirenda, Moffat J; Matengeni, Alfred; Berman, Josh; Mallewa, Jane; Chinomba, Gift S; Kayange, Noel; Allain, Theresa J; Chan, Adrienne K; Sodhi, Sumeet K; van Oosterhout, Joep J

    2016-12-12

    Hypertension and diabetes prevalence is high in Africans. Data from HIV infected populations are limited, especially from Malawi. Integrating care for chronic non-communicable co-morbidities in well-established HIV services may provide benefit for patients by preventing multiple hospital visits but will increase the burden of care for busy HIV clinics. Cross-sectional study of adults (≥18 years) at an urban and a rural HIV clinic in Zomba district, Malawi, during 2014. Hypertension and diabetes were diagnosed according to stringent criteria. Proteinuria, non-fasting lipids and cardio/cerebro-vascular disease (CVD) risk scores (Framingham and World Health Organization/International Society for Hypertension) were determined. The association of patient characteristics with diagnoses of hypertension and diabetes was studied using multivariable analyses. We explored the additional burden of care for integrated drug treatment of hypertension and diabetes in HIV clinics. We defined that burden as patients with diabetes and/or stage II and III hypertension, but not with stage I hypertension unless they had proteinuria, previous stroke or high Framingham CVD risk. Nine hundred fifty-two patients were enrolled, 71.7% female, median age 43.0 years, 95.9% on antiretroviral therapy (ART), median duration 47.7 months. Rural and urban patients' characteristics differed substantially. Hypertension prevalence was 23.7% (95%-confidence interval 21.1-26.6; rural 21.0% vs. urban 26.5%; p = 0.047), of whom 59.9% had stage I (mild) hypertension. Diabetes prevalence was 4.1% (95%-confidence interval 3.0-5.6) without significant difference between rural and urban settings. Prevalence of proteinuria, elevated total/high-density lipoprotein-cholesterol ratio and high CVD risk score was low. Hypertension diagnosis was associated with increasing age, higher body mass index, presence of proteinuria, being on regimen zidovudine/lamivudine/nevirapine and inversely with World Health

  6. Prevalence and associated factors of diabetes and impaired fasting glucose in Chinese hypertensive adults aged 45 to 75 years.

    Directory of Open Access Journals (Sweden)

    Xianhui Qin

    Full Text Available This study examined the prevalence of impaired fasting glucose (IFG and diabetes and their associated factors in 17,184 Chinese hypertensive adults aged 45-75 years.A cross-sectional investigation was carried out in a rural area of Lianyungang, China. Previously undiagnosed diabetes [fasting plasma glucose (FPG ≥ 7.0 mmol/l] and IFG (6.1-6.9 mmol/l were defined based on FPG concentration. Previously diagnosed diabetes was determined on the basis of self-report. Total diabetes included both previously diagnosed diabetes and previously undiagnosed diabetes.The prevalence of previously diagnosed diabetes, undiagnosed diabetes, and IFG were 3.4%, 9.8%, and 14.1%, respectively. About 74.2% of the participants with diabetes had not previously been diagnosed. In the multivariable logistic-regression model, older age, men, antihypertensive treatment, obesity (BMI ≥ 25 kg/m(2, abdominal obesity (waist circumference ≥ 90 cm for men and ≥ 80 cm for women, non-current smoking, a family history of diabetes, higher heart rate, lower physical activity levels, and inland residence (versus coastal were significantly associated with both total diabetes and previously undiagnosed diabetes. Furthermore, methylene- tetrahydrofolate reductase (MTHFR 677 TT genotype was an independent associated factor for total diabetes, and current alcohol drinking was an independent associated factor for previously undiagnosed diabetes. At the same time, older age, men, abdominal obesity, non-current smoking, current alcohol drinking, a family history of diabetes, higher heart rate, and inland residence (versus coastal were important independent associated factors for IFG.In conclusion, we found a high prevalence of diabetes in Chinese hypertensive adults. Furthermore, about three out of every four diabetic adults were undiagnosed. Our results suggest that population-level measures aimed at the prevention, identification (even if only based on the FPG evaluation, and

  7. Plasma proteomics classifiers improve risk prediction for renal disease in patients with hypertension or type 2 diabetes

    DEFF Research Database (Denmark)

    Pena, Michelle J; Jankowski, Joachim; Heinze, Georg

    2015-01-01

    OBJECTIVE: Micro and macroalbuminuria are strong risk factors for progression of nephropathy in patients with hypertension or type 2 diabetes. Early detection of progression to micro and macroalbuminuria may facilitate prevention and treatment of renal diseases. We aimed to develop plasma...... proteomics classifiers to predict the development of micro or macroalbuminuria in hypertension or type 2 diabetes. METHODS: Patients with hypertension (n = 125) and type 2 diabetes (n = 82) were selected for this case-control study from the Prevention of REnal and Vascular ENd-stage Disease cohort....... RESULTS: In hypertensive patients, the classifier improved risk prediction for transition in albuminuria stage on top of the reference model (C-index from 0.69 to 0.78; P diabetes, the classifier improved risk prediction for transition from micro to macroalbuminuria (C-index from 0...

  8. Changes in Systemic Hemodynamics in Hypertensive Patients with Diabetes Mellitus Type 2 Depending on the Type of Left Ventricular Remodeling

    Directory of Open Access Journals (Sweden)

    E.Yu. Gura

    2014-04-01

    The correlations with the main indicators of the intracardiac systemic hemodynamics confirm a single pathogenetic mechanism of the cardiovascular remodeling in patients with hypertension combined with type 2 diabetes.

  9. Effect of Home Blood Pressure Telemonitoring With Self-Care Support on Uncontrolled Systolic Hypertension in Diabetics

    National Research Council Canada - National Science Library

    Logan, Alexander G; Irvine, M Jane; McIsaac, Warren J; Tisler, Andras; Rossos, Peter G; Easty, Anthony; Feig, Denice S; Cafazzo, Joseph A

    2012-01-01

    .... In a pilot study we demonstrated that a home blood pressure telemonitoring system, which provided self-care messages on the smartphone of hypertensive diabetic patients immediately after each reading...

  10. A study evaluating prevalence of hypertension and risk factors affecting on blood pressure control among type 2 diabetes patients attending teaching hospital in Malaysia.

    Science.gov (United States)

    Abougalambou, Salwa Selim Ibrahim; Abougalambou, Ayman S

    2013-01-01

    Hypertension is extremely common disease found in patients with diabetes mellitus. Eighty to 90% of patients with type 2 diabetes mellitus will develop hypertension, and about 20% of hypertensive patients develop diabetes. The aim of this study was designed to assess the prevalence of hypertension and factors affecting the control of hypertension among type 2 diabetic patients. A total of 1077 type 2 diabetes mellitus patients were included in this study who attended at diabetes clinic of Universiti Sains Malaysia (USM) teaching hospital in Kelantan. All these patients were prospectively followed from January to December 2008. Logistic regression analysis was used to assess the independent effect of variables on hypertension. The prevalence of hypertension (BP>130/80 or on medication for high blood pressure) was 92.7%. A total 471 (47.2%) patients had achieved blood pressure targets ≤ 130/80 mmHg. The logistic regression indicated that hypertension was positively associated with age (P=0.040), BMI (P=0.027), HbA1c (P=0.046), and level of education (P=0.039). Hypertension is a common co-morbidity among diabetic patients. Hypertension was not controlled to the recommended levels of blood pressure in about one-half (52.8%) of diabetes patients. Age, BMI, HbA1c and level of education are factors affecting on hypertension. Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  11. [QT interval dispersion in hypertensive diabetics and in patients with hypertension with chronic heart failure without diabetes].

    Science.gov (United States)

    Radman, A; Murín, J; Bulas, J; Reptová, A; Ravingerová, T; Mikes, P; Kozliková, K; Ghanem, W; Jaber, J; Baqi, L

    2003-10-01

    Our aim was to: 1. compare QT dispersion from routine ECG in diabetic and no-diabetic patients with congestive heart failure, 2. describe associations between QT dispersion and circadian blood (BP) pressure variation in type 2 diabetic patients with congestive heart failure (CHF). 122 patients admitted to hospital due to CHF in the period between years 2000-2001 have been divided into 2 groups: group 1:70 patients (m: 40, f: 30, mean age 64.7 +/- 9 years) with type II diabetes mellitus (DM), group 2:52 patients (m: 28, f:24, mean age 62.5 +/- 10.9 years) without DM. Diagnosis of CHF was made clinically and proved by ECG and ECHO (EF 11.1 mmol/l). The QT interval was measured from the beginning of the QRS complex to the end of the T wave from routine 12-lead ECG. QT intervals were corrected for heart rate using Bazett's formula. QT dispersion (QTd) and rate corrected QT dispersion (QTc) were defined as the difference between the maximum and minimum QT and QTc intervals, respectively. Ambulatory blood pressure (AMBP) was measured by an oscillometic technique. Diabetic patients with CHF were divided both according to below and above the median QTc dispersion (65 ms). Chi-square and Student's t-test. Significant differences were assumed of p CHF had significantly longer QTc interval (maximum and minimum), QT dispersion and QTc dispersion compared with non-diabetic patients with CHF. Diabetic patients with CHF with QTc dispersion > 65 ms had significantly higher night systolic (133 +/- 14 vs. 112 +/- 14) and diastolic (80 +/- 11 vs. 65 +/- 6) BP and significantly higher night/day ratio for both systolic (0.94 +/- 0.05 vs. 0.86 +/- 0.06) and diastolic (0.89 +/- 0.07 vs. 0.80 +/- 0.05) compared with diabetic patients with CHF with QTc dispersion CHF are higher risk than non-diabetic. Our data describe both factors related to cardiovascular risk in diabetic patients with CHF-prolongation of the QT and QTc dispersion and reduced nocturnal blood pressure.

  12. Maturity-onset diabetes of the young--MODY. Molekylaergenetiske, patofysiologiske og kliniske karakteristika

    DEFF Research Database (Denmark)

    Hansen, Torben; Urhammer, Søren A; Pedersen, Oluf Borbye

    2002-01-01

    of diabetes. In contrast, MODY3 and some of the other MODY forms are characterised by major insulin secretory defects and severe hyperglycaemia associated with microvascular complications. About 25% of known MODY is caused by mutations in yet unknown genes and present results suggest that other monogenic......Maturity-onset diabetes of the young (MODY) is a genetically and clinically heterogeneous subtype of type 2 diabetes characterised by an early onset, an autosomal dominant inheritance, and a primary defect in insulin secretion. MODY comprises 2-5% of cases of type 2 diabetes. So far, six MODY genes...... have been identified (MODY1-6): hepatocyte nuclear factor (HNF-4 alpha), glucokinase, HNF-1 alpha, HNF-1 beta, insulin promoter factor 1(IPF-1), and neurogenic differentiation factor 1 (NEUROD1). MODY2 and MODY3 are the most common forms of MODY. Mutations in glucokinase/MODY2 result in a mild form...

  13. Medical Adherence in Diabetes Hypertension Comorbidity: A Reply ...

    African Journals Online (AJOL)

    2018-01-01

    Jan 1, 2018 ... particularly relevant to the developing world in which 80% of the global diabetic population resides. I would like to make the following observations with respect to this study. The study collected data through evaluation of patient medical records. However, adherence to medications in the study was defined.

  14. Increased dementia risk predominantly in diabetes mellitus rather than in hypertension or hyperlipidemia: a population-based cohort study

    OpenAIRE

    Fan, Yen-Chun; Hsu, Jung-Lung; Tung, Hong-Yi; Chou, Chia-Chi; Bai, Chyi-Huey

    2017-01-01

    Background The pathophysiology of insulin resistance-induced hypertension and hyperlipidemia might entail differences in dementia risk in cases with hypertension and hyperlipidemia without prior diabetes mellitus (DM). This study investigated whether incident hypertension, incident hyperlipidemia, or both, increased the dementia risk in patients with and without DM. Methods A nationwide retrospective cohort study was conducted. The study sample was obtained from the National Health Insurance ...

  15. [A cross-sectional study to assess cardiovascular risk in the children of parents with diabetes mellitus or arterial hypertension].

    Science.gov (United States)

    Gómez-García, A; Rangel-García, L; Alvarez-Aguilar, C

    2012-01-01

    Cardiovascular disease in adults is the first cause of death, and in adolescents under 15 years old, it is the third cause of death. The purpose of this study was to investigate which risk factors for cardiovascular disease have the children of parents with diabetes or hypertension. In a cross-sectional study conducted in the Family Medicine Unit No. 80 in Morelia, Michoacán, Mexico, were included 156 patients with diabetes mellitus, hypertension and without diabetes or hypertension (10 years of disease progression), and a biological child (age 7-15 years) to form pairs. Three groups were formed: child-parent with Diabetes; child-parent with Hypertension and child-parent without Diabetes or Hypertension. Medical history, body mass index, blood glucose, cholesterol, triglycerides, c-LDL, c-HDL and signs of metabolic syndrome were recorded. The frequency of signs of metabolic syndrome was higher in parents with Diabetes (28.8%), and in children of parents without either diabetes or hypertension (11.5%). In binomial children-parents with Diabetes, serum glucose (OR=4.50: 95% CI; 2.32-8.73, PDiabetes or Hypertension, the abdominal circumference (OR=3.429: 95% CI; 1.621-7.251, Pdiabetes mellitus or hypertension are at increased risk for developing cardiovascular disease. Longitudinal studies are required using non-pharmacological and pharmacological strategies that will have an impact on the most important risk factors for preventing cardiovascular disease. Copyright © 2011 Elsevier España, S.L. y SEMERGEN. All rights reserved.

  16. Association of acculturation and country of origin with self-reported hypertension and diabetes in a heterogeneous Hispanic population

    OpenAIRE

    Rodriguez Fátima; Hicks LeRoi S; López Lenny

    2012-01-01

    Abstract Background Hispanics are the fasting growing population in the U.S. and disproportionately suffer from chronic diseases such as hypertension and diabetes. Little is known about the complex interplay between acculturation and chronic disease prevalence in the growing and increasingly diverse Hispanic population. We explored the association between diabetes and hypertension prevalence among distinct U.S. Hispanic subgroups by country of origin and by degree of acculturation. Methods We...

  17. The role of diabetes and aging in the determinism of hypertension and the related cerebrovascular complications.

    Science.gov (United States)

    Malaguarnera, Michele; Vacante, Marco; Frazzetto, Paola Mariangela; Motta, Massimo

    2012-01-01

    Epidemiological studies carried out on a large sample (3191 elderly and 640 centenarians) with identical criteria and applying the actual diagnostic standards, have evidenced a high, statistically significant prevalence of diabetes mellitus type 2 (DMT2) (18.84%) in the elderly, as compared to the centenarians (7.50%). This aspect is correlated with the major frequency of maturity onset diabetes in elderly (MODE), compared to the centenarians, correlated also to the mortality of diabetes mellitus (DM) of long duration. The DMT2 and the aging interact in the determinism of vascular alterations, i.e., of the hypertension, and related cardio-cerebrovascular complications. The most frequently occurring hypertension in both the elderly and centenarians was always the systolic-isolated one. The prevalence of hypertension and acute myocardial infarction (AMI) was statistically significantly higher in diabetics, compared to the normoglycemic patients, in both the elderly and the centenarians. In addition, in a group of 914 elderly patients, being diabetics or normoglycemic at the start of the studies, but having neither AMI nor stroke at the baseline studies, after 5 years, these complications were more prevalent, significantly in statistical terms, in the diabetic subjects, compared to the normoglycemic ones. The increase of life-span causes an increase of the age when the aging phenomena appear, resulting in that the equal-age elderly people today are of better clinical conditions, compared to the previous periods. The increased life span with a consequent progressive aging of the population causes a worse general clinical state of the elderly population, characterized by polypathologies, frailty, and appearance of cognitive deficits or incapabilities for performing manual or instrumental activities. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Cardioprotective and anti-hypertensive effects of Prosopis glandulosa in rat models of pre-diabetes.

    Science.gov (United States)

    Huisamen, B; George, C; Dietrich, D; Genade, S

    2013-03-01

    Obesity and type 2 diabetes present with two debilitating complications, namely, hypertension and heart disease. The dried and ground pods of Prosopis glandulosa (commonly known as the Honey mesquite tree) which is part of the Fabaceae (or legume) family are currently marketed in South Africa as a food supplement with blood glucose-stabilising and anti-hypertensive properties. We previously determined its hypoglycaemic effects, and in the current study we determined the efficacy of P glandulosa as anti-hypertensive agent and its myocardial protective ability. Male Wistar rats were rendered either pre-diabetic (diet-induced obesity: DIO) or hypertensive (high-fat diet: HFD). DIO animals were treated with P glandulosa (100 mg/kg/day for the last eight weeks of a 16-week period) and compared to age-matched controls. Hearts were perfused ex vivo to determine infarct size. Biometric parameters were determined at the time of sacrifice. Cardiac-specific insulin receptor knock-out (CIRKO) mice were similarly treated with P glandulosa and infarct size was determined. HFD animals were treated with P glandulosa from the onset of the diet or from weeks 12-16, using captopril (50 mg/kg/day) as the positive control. Blood pressure was monitored weekly. DIO rats and CIRKO mice: P glandulosa ingestion significantly reduced infarct size after ischaemia-reperfusion. Proteins of the PI-3-kinase/PKB/Akt survival pathway were affected in a manner supporting cardioprotection. HFD model: P glandulosa treatment both prevented and corrected the development of hypertension, which was also reflected in alleviation of water retention. P glandulosa was cardioprotective and infarct sparing as well as anti-hypertensive without affecting the body weight or the intra-peritoneal fat depots of the animals. Changes in the PI-3-kinase/PKB/Akt pathway may be causal to protection. Results indicated water retention, possibly coupled to vasoconstriction in the HFD animals, while ingestion of P glandulosa

  19. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    DEFF Research Database (Denmark)

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA...... was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

  20. Characteristics of white coat hypertension in Chinese Han patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Zhou, Jianguang; Liu, Changyun; Shan, Peijia; Zhou, Yingqi; Xu, Erli; Ji, Yufeng

    2014-01-01

    This study documented the prevalence and clinical features of white coat hypertension (WCH) among Chinese Han patients with type 2 diabetes mellitus (T2DM). Clinic and ambulatory blood pressure (BP) measurements were compared in 856 patients with T2DM to determine the frequency of WCH (WCH was defined as clinical blood pressure ≥140/90 mmHg and daytime blood pressure hypertension. Age, course of T2DM, male WC were independent protective factors, whereas female sex, smoking and alcohol consumption were independent risk factors for WCH in T2DM. Non-dippers and reverse dippers made up larger proportion of the WCH group (p hypertension (EH), and WCH patients also exhibit significant differences in clinical parameters.

  1. Total plasma homocysteine is associated with hypertension in Type I diabetic patients

    DEFF Research Database (Denmark)

    Neugebauer, S; Tarnow, L; Stehouwer, C D

    2002-01-01

    between plasma homocysteine concentrations, methylenetetrahydrofolate reductase gene polymorphism, hypertension, diabetic microvascular and macrovascular complications associated with kidney function. METHODS: Vascular complications, hypertension, methylenetetrahydrofolate reductase genotype (RFLP...... with Hinf I digestion), and total plasma homocysteine (HPLC) were investigated in 389 well-characterized Type I (insulin-dependent) diabetic patients with normal (GFR> or=75 ml x min(-1) x (1.73 m(2))(-1); n=273), or impaired renal function (GFR ... with microvascular and macrovascular complications showed higher total plasma homocysteine concentrations than those without complications. However, after the data for GFR (main determinant for plasma homocysteine) was adjusted we observed that plasma homocysteine concentrations greater than 8.6 micro mol...

  2. Differential impact of diabetes mellitus type II and arterial hypertension on collateral artery growth and concomitant macrophage accumulation.

    Science.gov (United States)

    Ito, Wulf D; Lund, Natalie; Sager, Hendrik; Becker, Wiebke; Wenzel, Ulrich

    2015-01-01

    Diabetes mellitus type II and arterial hypertension are major risk factors for peripheral arterial disease and have been considered to reduce collateral growth (arteriogenesis). Collateral growth proceeds through different stages. Vascular proliferation and macrophage accumulation are hallmarks of early collateral growth. We here compare the impact of arterial hypertension and diabetes mellitus type II on collateral proliferation (Brdu incorporation) and macrophage accumulation (ED 2 staining) as well as collateral vessel function (collateral conductance) in a rat model of peripheral vascular disease (femoral artery occlusion), diabetes mellitus type II (Zucker fatty diabetic rats and Zucker lean rat controls) and arterial hypertension (induced via clip placement around the right renal arteriy). We furthermore tested the impact of monocyte chemoattractant protein-1 (MCP‑1) on collateral proliferation and macrophage accumulation in these models Diabetic animals showed reduced vascular proliferation and macrophage accumulation, which however did not translate into a change of collateral conductance. Hypertensive animals on the contrary had reduced collateral conductances without altered macrophage accumulation and only a marginal reduction in collateral proliferation. Infusion of MCP‑1 only enhanced vascular proliferation in diabetic animals. These findings illustrate that impaired monocyte/macrophage recruitment is responsible for reduced collateral growth under diabetic conditions but not in arterial hypertension suggesting that diabetes mellitus in particular affects early stages of collateral growth whereas hypertension has its impact on later remodeling stages. Successful pro-arteriogenic treatment strategies in a patient population that presents with diabetes mellitus and arterial hypertension need to address different stages of collateral growth and thus different molecular and cellular targets simultaneously.

  3. Endothelial Dysfunction and Its Correction in Patients with Essential Hypertension and Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    A.S. Shalimova

    2014-03-01

    Full Text Available The article provides the results of studying the effectiveness of α-lipoic acid impact as a part of complex therapy on endothelial dysfunction in patients with essential hypertension and type 2 diabetes mellitus. There were revealed a significant improvement in metabolic homeostasis, decreased severity of endothelial dysfunction, reduced levels of inflammatory cytokines under additional use of α-lipoic acid compared with standard therapy.

  4. Betel nut chewing is associated with hypertension in Taiwanese type 2 diabetic patients.

    Science.gov (United States)

    Tseng, Chin-Hsiao

    2008-03-01

    Betel nut chewing is associated with oral cancers and diabetes. This study investigated whether betel nut chewing could be associated with hypertension in Taiwanese patients with type 2 diabetes mellitus (T2DM). The data of a total of 81,226 (37,226 men and 44,000 women) patients with T2DM obtained from a cross-sectional telephone survey in a national sample of diabetic patients in Taiwan were analyzed. Hypertension was defined by a positive history or reported systolic blood pressure>or=140 mmHg and/or diastolic blood pressure>or=90 mmHg. Analyses were performed in separate sexes with consideration paid to the potential confounding effects of age, diabetic duration, body mass index and smoking. The prevalences of betel nut chewing in men and women were 20.4% and 1.1%, respectively. Betel nut chewing was more common in the younger age groups of the male sex. The multivariate-adjusted odds ratios for hypertension in chewers vs. non-chewers were 1.067 (1.007-1.131) and 1.897 (1.534-2.346) for men and women, respectively. In multiple linear regression, although no adjustment was made for the use of antihypertensive agents, betel nut chewing was significantly associated with blood pressure, with regression coefficients of 0.958+/-0.163 (SEM) for systolic and 0.441+/-0.108 for diastolic blood pressure in men; and the respective values for women were 1.805+/-0.618 and 1.198+/-0.393. In conclusion, betel nut chewing was significantly associated with hypertension in Taiwanese patients with T2DM and the association was stronger in women.

  5. The effects of shift work on sleeping quality, hypertension and diabetes in retired workers.

    Directory of Open Access Journals (Sweden)

    Yanjun Guo

    Full Text Available BACKGROUND: Shift work has been associated with adverse health effects by disturbing circadian rhythms. However,its potential long-term health effects and the persistent effects after leaving shifts have not been well established. METHODS AND RESULTS: We studied 26,463 workers from Tongji-Dongfeng Cohort in China. All the participants are retired employees of Dongfeng Motor Company. Information on demographics, occupational history and medical history were gathered through questionnaires. After adjusting potential confounders in the logistic regression models, shift work was associated with poor sleeping quality, diabetes and hypertension independently. We observed significant effects of shift work on poor sleeping quality, diabetes and hypertension; the ORs (95%CI are 1.18 (1.09-1.27, 1.10 (1.03-1.17 and 1.05 (1.01-1.09 respectively. In the further analysis, we found elevated ORs (95%CI for participants with poor sleeping quality, the ORs (95%CI are 1.34 (1.08-1.60, 1.13 (1.05-1.21, 1.05 (1.03-1.07 and 1.05 (1.01-1.09 for 1-4, 5-9, 10-19, ≥20 years of shift work respectively. However, with the extension of leaving shift work duration, the effects of shift work on sleep quality gradually reduced. CONCLUSIONS: Shift work may be an independent risk factor for sleeping quality, diabetes and hypertension even in retired workers. Applicable intervention strategies are needed for prevention of sleep loss, diabetes, and hypertension for shift workers.

  6. Prevalence of hypertension and diabetes in residents from Lima and Callao, Peru

    OpenAIRE

    Revilla, Luis; Dirección General de Epidemiología, Ministerio de Salud. Lima, Perú. Médico epidemiólogo; López, Tania; Dirección General de Epidemiología, Ministerio de Salud. Lima, Perú. médico epidemiólogo, magíster en Gerencia y Gobierno, doctor en Salud Pública; Sánchez, Sixto; Hospital Nacional Dos de Mayo. Lima, Perú. médico ginecólogo obstetra, magíster en Epidemiología, doctor en Salud Pública; Yasuda, Myriam; Instituto Nacional de Salud. Lima, Perú. médico patólogo clínico; Sanjinés, Giovanna; Instituto Nacional de Salud. Lima, Perú. licenciada en Tecnología Médica

    2014-01-01

    Objectives. To determine the prevalence of hypertension and diabetes in residents of districts in metropolitan Lima and Callao, Peru. Materials and methods. This was a cross-sectional study conducted during September 2006 in people aged 15 years and older, residing in metropolitan Lima and Callao. Participants were selected using a sample of “conglomerados” (neighborhoods) in three stages. Standardized procedures were used to measure weight, height, waist circumference, blood pressure and blo...

  7. Age, homocysteine, and oxidative stress: relation to hypertension and type 2 diabetes mellitus.

    Science.gov (United States)

    Dominguez, Ligia J; Galioto, Antonio; Pineo, Antonella; Ferlisi, Anna; Ciaccio, Marcello; Putignano, Ernesto; Belvedere, Mario; Costanza, Giuseppe; Barbagallo, Mario

    2010-02-01

    Hyperhomocysteinemia and oxidative stress are independent risk factors for cardiovascular events, which occur more frequently in old age. We evaluated these parameters in relation to age and the presence of hypertension and type 2 diabetes mellitus. Two hundred eighty-two subjects (female/male: 142/140; 141 were >65 years and 141 were age 73.9 +/- 6.6 years and 52.5 +/- 8.2 years, respectively) were randomly recruited from those attending our institution. Blood pressure, anthropometric parameters, oxidative stress parameters (reactive oxygen species [ROS] and malondialdehyde [MDA]), and homocysteine levels were evaluated in participants. Homocysteine (2.9 +/- 0.06 vs. 2.3 +/- 0.03 micromol/L, p oxidative stress (ROS: 10.8 +/- 0.3 vs. 8.1 +/- 0.3 mmol/L, p diabetes. However, homocysteine and MDA were not significantly different in older vs. younger hypertensive subjects (homocysteine: 3.0 +/- 0.03 vs. 2.9 +/- 0.04 micromol/L, p = NS; MDA: 1.7 +/- 0.07 vs. 1.4 +/- 0.06 nmol/mL, p = NS) and in older vs. younger diabetic hypertensive subjects (homocysteine: 3.02 +/- 0.05 vs. 2.9 +/- 0.05 micromol/L, p = NS; ROS: 10.7 +/- 0.7 vs. 9.7 +/- 0.8 mmol/L, p = NS; MDA: 1.6 +/- 0.10 vs. 1.5 +/- 0.12 nmol/mL, p = NS). Aging is accompanied by elevated homocysteine and oxidative stress levels similar to those observed in younger subjects with hypertension or diabetes mellitus, independent of age. Hence, these conditions appear to accelerate the age-dependent increase in homocysteine and oxidative stress.

  8. The Effects of Shift Work on Sleeping Quality, Hypertension and Diabetes in Retired Workers

    Science.gov (United States)

    Guo, Yanjun; Liu, Yuewei; Huang, Xiji; Rong, Yi; He, Meian; Wang, Youjie; Yuan, Jing; Wu, Tangchun; Chen, Weihong

    2013-01-01

    Background Shift work has been associated with adverse health effects by disturbing circadian rhythms. However,its potential long-term health effects and the persistent effects after leaving shifts have not been well established. Methods and Results We studied 26,463 workers from Tongji-Dongfeng Cohort in China. All the participants are retired employees of Dongfeng Motor Company. Information on demographics, occupational history and medical history were gathered through questionnaires. After adjusting potential confounders in the logistic regression models, shift work was associated with poor sleeping quality, diabetes and hypertension independently. We observed significant effects of shift work on poor sleeping quality, diabetes and hypertension; the ORs (95%CI) are 1.18 (1.09–1.27), 1.10 (1.03–1.17) and 1.05 (1.01–1.09) respectively. In the further analysis, we found elevated ORs (95%CI) for participants with poor sleeping quality, the ORs (95%CI) are 1.34 (1.08–1.60), 1.13 (1.05–1.21), 1.05 (1.03–1.07) and 1.05 (1.01–1.09) for 1–4, 5–9, 10–19, ≥20 years of shift work respectively. However, with the extension of leaving shift work duration, the effects of shift work on sleep quality gradually reduced. Conclusions Shift work may be an independent risk factor for sleeping quality, diabetes and hypertension even in retired workers. Applicable intervention strategies are needed for prevention of sleep loss, diabetes, and hypertension for shift workers. PMID:23976988

  9. Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine

    Directory of Open Access Journals (Sweden)

    Cesar Romaro Pozzobon

    2014-07-01

    Full Text Available Background: Antihypertensive drugs are used to control blood pressure (BP and reduce macro- and microvascular complications in hypertensive patients with diabetes. Objectives: The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan. Methods: Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day or losartan (100 mg/day. Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascular parameters using applanation tonometry, pulse wave velocity (PWV, and flow-mediated dilation (FMD of the brachial artery. Results: A total of 42 patients were evaluated (21 in each group, with a predominance of women (71% in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years, with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic and 84 ± 8 mmHg (diastolic; losartan group: 153 ± 19 mmHg (systolic and 90 ± 9 mmHg (diastolic]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025 and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045 were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups. Conclusions: Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

  10. Metabolic syndrome, dyslipidemia, hypertension and type 2 diabetes in youth: from diagnosis to treatment

    OpenAIRE

    Halpern, Alfredo; Mancini, Marcio C; Magalhães, Eliane C M; Fisberg, Mauro; Radominski, Rosana; Bertolami, Marcelo C; Bertolami, Adriana; Edna de Melo, Maria; Teresa Zanella, Maria; Queiroz, Marcia S; Nery, Marcia

    2010-01-01

    Abstract Overweight and obesity in youth is a worldwide public health problem. Overweight and obesity in childhood and adolescents have a substantial effect upon many systems, resulting in clinical conditions such as metabolic syndrome, early atherosclerosis, dyslipidemia, hypertension and type 2 diabetes (T2D). Obesity and the type of body fat distribution are still the core aspects of insulin resistance and seem to be the physiopathologic links common to metabolic syndrome,...

  11. Mere historie og kulturarv?

    DEFF Research Database (Denmark)

    Olesen, Marie Bonde; Brunbech, Peter

    2016-01-01

    Præsentation af HistorieLab og om folkeskolereformen og kulturinstitutionernes muligheder og udfordringer i samarbejdet med skolerne......Præsentation af HistorieLab og om folkeskolereformen og kulturinstitutionernes muligheder og udfordringer i samarbejdet med skolerne...

  12. Independent association of waist circumference with hypertension and diabetes in African American women, South Carolina, 2007-2009.

    Science.gov (United States)

    Warren, Tatiana Y; Wilcox, Sara; Dowda, Marsha; Baruth, Meghan

    2012-01-01

    Obesity is associated with hypertension and diabetes, which are independent risk factors for cardiovascular disease (CVD); 53% of African American women are obese. Of the approximately 44% of African American women who are hypertensive, more than 87% are overweight or obese. Additionally, more than twice as many African American women (13.1%) as white women (6.1%) have been diagnosed with type 2 diabetes. Obesity is usually measured using body mass index (BMI). However, abdominal adiposity may be more predictive of CVD risk than BMI. This study investigates the independent association of waist circumference with hypertension and diabetes in African American women. As part of the Faith, Activity, and Nutrition (FAN) program, we recruited 843 African American women (mean age 53.8 y [SD, 14.1 y]) from African Methodist Episcopal churches. If a participant reported she had hypertension or had measured systolic blood pressure at or higher than 140 mm Hg or measured diastolic blood pressure at or higher than 90 mm Hg, she was classified as having hypertension. To assess increased health risks associated with waist circumference, we used the World Health Organization's standards to categorize waist circumference as normal risk (waist circumference 88 cm). We used logistic regression models to test predictors of hypertension and diabetes. Of 843 study participants, 205 had diabetes and 545 were hypertensive. Women with a waist circumference of 88 cm or more were at increased risk for hypertension (odds ratio [OR] = 7.17, P independently associated with a 5-fold risk in hypertension and diabetes in African American women.

  13. Reliability of peripheral arterial tonometry in patients with heart failure, diabetic nephropathy and arterial hypertension.

    Science.gov (United States)

    Weisrock, Fabian; Fritschka, Max; Beckmann, Sebastian; Litmeier, Simon; Wagner, Josephine; Tahirovic, Elvis; Radenovic, Sara; Zelenak, Christine; Hashemi, Djawid; Busjahn, Andreas; Krahn, Thomas; Pieske, Burkert; Dinh, Wilfried; Düngen, Hans-Dirk

    2017-08-01

    Endothelial dysfunction plays a major role in cardiovascular diseases and pulse amplitude tonometry (PAT) offers a non-invasive way to assess endothelial dysfunction. However, data about the reliability of PAT in cardiovascular patient populations are scarce. Thus, we evaluated the test-retest reliability of PAT using the natural logarithmic transformed reactive hyperaemia index (LnRHI). Our cohort consisted of 91 patients (mean age: 65±9.7 years, 32% female), who were divided into four groups: those with heart failure with preserved ejection fraction (HFpEF) ( n=25), heart failure with reduced ejection fraction (HFrEF) ( n=22), diabetic nephropathy ( n=21), and arterial hypertension ( n=23). All subjects underwent two separate PAT measurements at a median interval of 7 days (range 4-14 days). LnRHI derived by PAT showed good reliability in subjects with diabetic nephropathy (intra-class correlation (ICC) = 0.863) and satisfactory reliability in patients with both HFpEF (ICC = 0.557) and HFrEF (ICC = 0.576). However, in subjects with arterial hypertension, reliability was poor (ICC = 0.125). We demonstrated that PAT is a reliable technique to assess endothelial dysfunction in adults with diabetic nephropathy, HFpEF or HFrEF. However, in subjects with arterial hypertension, we did not find sufficient reliability, which can possibly be attributed to variations in heart rate and the respective time of the assessments. Clinical Trial Registration Identifier: NCT02299960.

  14. Leisure sedentary time is differentially associated with hypertension, diabetes mellitus, and hyperlipidemia depending on occupation.

    Science.gov (United States)

    Lim, Man Sup; Park, Bumjung; Kong, Il Gyu; Sim, Songyong; Kim, So Young; Kim, Jin-Hwan; Choi, Hyo Geun

    2017-03-23

    Sedentary behavior is considered an independent cause of cardio-metabolic diseases, regardless of physical activity level and obesity. Few studies have reported the association between leisure sedentary time and cardio-vascular diseases in terms of occupation. We performed a cross-sectional study using data from the Korean Community Health Survey (KCHS) for 240,086 participants assessed in 2011 and 2013. Occupation was categorized into four groups: farmer or fisherman, laborer, and soldier (Group I); service worker, salesperson, technician, mechanic, production worker, and engineer (Group II); manager, expert, specialist, and clerk (Group III); and unemployed (Group IV). Leisure sedentary time was divided into five groups: 0 h, 1 h, 2 h, 3 h, and 4+ h. The association between leisure sedentary time on weekdays and hypertension/diabetes mellitus/hyperlipidemia for different occupations was analyzed using simple and multiple logistic regression analyses with complex sampling. In Groups I, II and III, no length of sedentary time was associated with hypertension, and only 3 h or 4+ h of sedentary time was associated with diabetes mellitus and hyperlipidemia. Group IV showed a significant association with hypertension and diabetes mellitus for the 2 h, 3 h, and 4+ h sedentary times. The unemployed are more susceptible than other occupation groups to cardio-metabolic diseases when leisure time is sedentary.

  15. Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: A systematic comparison of their impact on cognition.

    Science.gov (United States)

    van den Berg, Esther; Kloppenborg, Raoul P; Kessels, Roy P C; Kappelle, L Jaap; Biessels, Geert Jan

    2009-05-01

    Vascular risk factors, such as type 2 diabetes mellitus, hypertension, dyslipidemia and obesity, have been associated with an increased risk of cognitive dysfunction, particularly in the elderly. The aim of this systematic review was to compare these risk factors with regard to the nature and magnitude of the associated cognitive decrements. Cross-sectional and longitudinal studies that assessed cognitive functioning in non-demented persons in relation to diabetes/impaired glucose metabolism (k = 36), hypertension (k = 24), dyslipidemia (k = 7) and obesity (k = 6) and that adjusted or matched for age, gender and education were included. When possible, effect sizes (Cohen's d) were computed per cognitive domain. Diabetes and hypertension were clearly associated with cognitive decrements; the results for obesity and dyslipidemia were less consistent. Effect sizes were moderate (median approximately -0.3) for all risk factors. Decline was found in all cognitive domains, although the effects on cognitive speed, mental flexibility and memory were most consistent. Methodological aspects of included studies and implications of these findings are discussed.

  16. Free access to hypertension and diabetes medicines among the elderly: a reality yet to be constructed.

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Fassa, Anaclaudia Gastal; Facchini, Luiz Augusto; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Rodrigues, Maria Aparecida; Domingues, Marlos Rodrigues; Bertoldi, Andréa Dâmaso

    2010-06-01

    The study evaluated free access to hypertension and diabetes medicines and the reasons reported for lack of access. The sample included 4,003 elderly people living in Primary Care Unit coverage areas from 41 Southern and Northeastern Brazilian cities. Free access was higher in the Northeast (62.4%). The strategy of the Family Health Program (Programa Saúde da Família - PSF) was more effective in providing access than the traditional model, with higher results in the Northeast (61.2%) than in the South (39.6%). Around 20% of medicines included in the Hypertension and Diabetes Program and 26% of those included in the National Essential Medicines List (RENAME) were paid out of pocket. In the Northeast, 25% of insulin and 32% of oral antidiabetics were paid out of pocket. Unavailability in the public sector and a lack of money determined the lack of access. Although the PSF, Hypertension and Diabetes Program and RENAME expanded free access, supplies were insufficient. A greater connection between programs and a clear definition of responsibilities can improve medicine acquisition process, increasing the effectiveness of pharmaceutical assistance.

  17. Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income.

    Science.gov (United States)

    Gagné, Thierry; Veenstra, Gerry

    2017-01-01

    A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001-2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (ORHT = .98, 95% CI (.97, .99); ORDM = .93, 95% CI (.92, .94)) and White women (ORHT = .95, 95% CI (.95, .96); ORDM = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (ORHT = .99, 95% CI (.92, 1.06); ORDM = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (ORHT = .86, 95% CI (.80, .92); ORDM = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.

  18. History of hypertension, heart disease, and diabetes and ovarian cancer patient survival

    DEFF Research Database (Denmark)

    Minlikeeva, Albina N; Freudenheim, Jo L; Cannioto, Rikki A

    2017-01-01

    has not been studied extensively, particularly according to histological subtype. METHODS: Using pooled data from fifteen studies participating in the Ovarian Cancer Association Consortium, we examined the associations between history of hypertension, heart disease, diabetes, and medications taken...... strata of histological subtypes. RESULTS: History of diabetes was associated with increased risk of mortality (n = 7,674; HR = 1.12; 95% CI = 1.01-1.25). No significant mortality associations were observed for hypertension (n = 6,482; HR = 0.95; 95% CI = 0.88-1.02) or heart disease (n = 4,252; HR = 1...... was inversely associated with mortality, HR = 0.71; 95% CI = 0.53-0.94. CONCLUSIONS: Histories of hypertension, diabetes, and use of diuretics, beta blockers, insulin, and oral antidiabetic medications may influence the survival of ovarian cancer patients. Understanding mechanisms for these observations could...

  19. Leisure sedentary time is differentially associated with hypertension, diabetes mellitus, and hyperlipidemia depending on occupation

    Directory of Open Access Journals (Sweden)

    Man Sup Lim

    2017-03-01

    Full Text Available Abstract Background Sedentary behavior is considered an independent cause of cardio-metabolic diseases, regardless of physical activity level and obesity. Few studies have reported the association between leisure sedentary time and cardio-vascular diseases in terms of occupation. Methods We performed a cross-sectional study using data from the Korean Community Health Survey (KCHS for 240,086 participants assessed in 2011 and 2013. Occupation was categorized into four groups: farmer or fisherman, laborer, and soldier (Group I; service worker, salesperson, technician, mechanic, production worker, and engineer (Group II; manager, expert, specialist, and clerk (Group III; and unemployed (Group IV. Leisure sedentary time was divided into five groups: 0 h, 1 h, 2 h, 3 h, and 4+ h. The association between leisure sedentary time on weekdays and hypertension/diabetes mellitus/hyperlipidemia for different occupations was analyzed using simple and multiple logistic regression analyses with complex sampling. Results In Groups I, II and III, no length of sedentary time was associated with hypertension, and only 3 h or 4+ h of sedentary time was associated with diabetes mellitus and hyperlipidemia. Group IV showed a significant association with hypertension and diabetes mellitus for the 2 h, 3 h, and 4+ h sedentary times. Conclusions The unemployed are more susceptible than other occupation groups to cardio-metabolic diseases when leisure time is sedentary.

  20. Karotinaemi hos patient med excessivt betakarotinfødeindtag og dysreguleret diabetes mellitus

    DEFF Research Database (Denmark)

    Mikkelsen, Carsten Sauer; Mikkelsen, Dorthe Bisgaard; Lindegaard, Hanne Merete

    2009-01-01

    A case of carotinaemia in a patient with excessive beta-carotene food-intake, diabetes mellitus and physiological amenorrhea is reported. The patient developed yellow discolouration in the palms and the soles of her feet. Blood samples showed a significantly increased lever of serum beta-carotene......A case of carotinaemia in a patient with excessive beta-carotene food-intake, diabetes mellitus and physiological amenorrhea is reported. The patient developed yellow discolouration in the palms and the soles of her feet. Blood samples showed a significantly increased lever of serum beta...

  1. Hypertensive response to exercise in dipper and non-dipper normotensive diabetics.

    Science.gov (United States)

    Kucukdurmaz, Zekeriya; Karavelioglu, Yusuf; Karapinar, Hekim; Gul, Ibrahim; Yilmaz, Ahmet; Yarlioglues, Mikail; Akpek, Mahmut; Kaya, Mehmet Gungor

    2014-01-01

    Non-dipper blood pressure (NDP) as an indicator of autonomic dysfunction could be associated with hypertensive response to exercise (HRE) in diabetic patients. HRE was determined as a predictor of development of unborn hypertension. We aimed to investigate if any correlation among NDP and HRE in normotensive type 2 diabetic patients. A total of 59 consecutive type 2 diabetic patients without history of hypertension and with normal blood pressure (BP) on ambulatory blood pressure monitoring (ABPM) were enrolled to the study. We divided the study population in to two groups depending on their BP on ABPM as dipper (group 1) or non-dipper (group 2). There were 22 patients (mean age 49.5 ± 7 and 10 male) in group 1 and 37 patients (mean age 53.1 ± 10 and 14 male) in group 2. Daytime diastolic and mean BP of dippers and night time systolic and mean BP of non-dippers were significantly higher. HRE was not significantly different between groups (59% vs. 62%, p = 0.820). Hemodynamic parameters during the exercise test were similar. At multivariate linear regression analysis, resting office systolic blood pressure (SBP) (r = 0.611, p age (r = 0.321, p = 0.010) were independently correlated with peak exercises SBP. Logistic regression analyses identified the resting office SBP (OR 1.191, 95% CI 1.080-1.313; p age (OR 1.161, 95% CI 1.038-1.298; p = 0.012) were independent predictors of HRE. This study revealed that HRE is not related with non-dipper BP in diabetic patients. This study could inspire to further studies to explore the main reasons of HRE in diabetes mellitus.

  2. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  3. Characteristics of government workers and association with diabetes and hypertension in the Cook Islands.

    Science.gov (United States)

    Tairea, K; Kool, B; Harries, A D; Bissell, K; Gounder, S; Hill, P C; Avare, T; Fariu, R

    2014-06-21

    Twenty government departments in Rarotonga, Cook Islands. To determine the characteristics, presence of selected non-communicable disease (NCD) risk factors and prevalence of diabetes mellitus (DM) and hypertension among government workers who participated in 'wellness checks' in 2012. Cross-sectional study involving analysis of survey data. Of 598 employees, 70% were aged 25-54 years and 55% were female. Two thirds were obese (body mass index ⩾30 kg/m(2)), and 76% had low levels of fruit and vegetable consumption. Of 50 (8.4%) participants diagnosed with DM (random blood glucose ⩾11 mmol/l, fasting ⩾7 mmol/l), 30 were self-reported and 20 were based on blood glucose. Of the 206 (34.4%) diagnosed with hypertension (systolic ⩾140 and/or diastolic ⩾90), 71 were self-reported and 135 were based on blood pressure measurements. Obesity was associated with hypertension (OR 2.79, 95%CI 1.4-5.4), but not with DM. No relationship was observed between fruit and vegetable consumption and presence or absence of DM or hypertension. This study identified a high prevalence of obesity and hypertension among government employees in the Cook Islands, risk factors that are associated with NCDs such as DM and cardiovascular disease. 'Wellness checks' pave the way for interventions in workplace settings to prevent and better manage these diseases through early diagnosis, risk management, treatment and supportive public health policies.

  4. Hypertensive subjects with type-2 diabetes, the sympathetic nervous system, and treatment implications.

    Science.gov (United States)

    Coats, Andrew J S; Cruickshank, John M

    2014-07-01

    Central obesity is closely linked to hypertension and type-2 diabetes (DM2) in young/middle-age. In the elderly, systolic hypertension is a reflection of aging/stiff arteries. Diastolic (± systolic) hypertension in young/middle-age is accompanied by increased sympathetic nerve activity, particularly in the presence of the metabolic syndrome or DM2. High beta-receptor density (Bmax) and cyclic AMP (cAMP) levels in human lymphocytes, independent of blood pressure, are associated with a high risk of myocardial infarction (not stroke-risk, which is dependent on blood pressure). This has treatment implications in the young/middle-aged hypertensive subject. Antihypertensive agents that increase sympathetic nerve activity e.g. dihydropyridine calcium blockers, angiotensin receptor blockers, and thiazide-type diuretics, do not reduce (and may increase) the risk of myocardial infarction. Beta-1 blockade, effective in reversing and stabilising coronary atheromataous plaque, and with possible anti-tumor properties, is superior to ACE-inhibition, and is the treatment of choice in young/middle-aged hypertension with DM2. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Potassium, calcium, magnesium, and sodium levels in biological samples of hypertensive and nonhypertensive diabetes mellitus patients.

    Science.gov (United States)

    Afridi, Hassan Imran; Kazi, Tasneem Gul; Kazi, Naveed; Jamali, Mohammad Khan; Arain, Mohammad Bilal; Jalbani, Nusrst; Sarfaraz, Raja Adil; Shah, Afzal; Kandhro, Ghulam Abbas; Shah, Abdul Qadir; Baig, Jameel Ahmed

    2008-09-01

    There is accumulating evidence that the metabolism of several essential elements is altered in diabetes mellitus and that these nutrients might have specific roles in the pathogenesis and progress of this disease. The aim of the present study was to compare the level of essential elements, potassium (K), calcium (Ca), magnesium (Mg), and sodium (Na), in biological samples (whole blood, urine, and scalp hair) of patients who have hypertensive diabetes mellitus type 2 (n = 254) and nonhypertensive diabetes mellitus type 2 (n = 228) with those of nondiabetic as control subjects (n = 182; age range of both genders 45-75). The element concentrations were measured by means of an atomic absorption spectrophotometer after microwave-induced acid digestion. The validity and accuracy was checked by conventional wet acid digestion method and using certified reference materials. The overall recoveries of all elements were found in the range of 99.1-99.9% of certified values. The results of this study showed that the mean values of K, Mg, and Ca were significantly reduced, while Na level were higher in blood and scalp hair samples of hypertensive diabetic (HD) patients and nonhypertensive diabetic (NHD) patients as compared to control subjects of both genders (p diabetic patient was found to be higher, but it was not significant (p = 0.05).The urinary levels of these elements were found to be higher in both HD and NHD patients than in the age-matched healthy controls. These results are consistent with those obtained in other studies, confirming that deficiency and efficiency of some essential trace metals may play a role in the development of diabetes mellitus.

  6. Blockade of the renin-angiotensin system improves cerebral microcirculatory perfusion in diabetic hypertensive rats.

    Science.gov (United States)

    Estato, Vanessa; Obadia, Nathalie; Carvalho-Tavares, Juliana; Freitas, Felipe Santos; Reis, Patrícia; Castro-Faria Neto, Hugo; Lessa, Marcos Adriano; Tibiriçá, Eduardo

    2013-05-01

    We examined the functional and structural microcirculatory alterations in the brain, skeletal muscle and myocardium of non-diabetic spontaneously hypertensive rats (SHR) and diabetic SHR (D-SHR), as well as the effects of long-term treatment with the angiotensin AT1-receptor antagonist olmesartan and the angiotensin-converting enzyme inhibitor enalapril. Diabetes was experimentally induced by a combination of a high-fat diet with a single low dose of streptozotocin (35 mg/kg, intraperitoneal injection). D-SHR were orally administered with olmesartan (5 mg/kg/day), enalapril (10 mg/kg/day) or vehicle for 28 days, and compared with vehicle-treated non-diabetic SHR or normotensive non-diabetic Wistar-Kyoto rats. The cerebral and skeletal muscle functional capillary density of pentobarbital-anesthetized rats was assessed using intravital fluorescence videomicroscopy. Chronic treatment with olmesartan or enalapril significantly lowered blood pressure and reversed brain functional capillary rarefaction. Brain oxidative stress was reduced to non-diabetic control levels in animals treated with olmesartan or enalapril. Histochemical analysis of the structural capillary density showed that both olmesartan and enalapril increased the capillary-to-fiber ratio in skeletal muscle and the capillary-to-fiber volume density in the left ventricle. Olmesartan and enalapril also prevented collagen deposition and the increase in cardiomyocyte diameter in the left ventricle. Our results suggest that the association between hypertension and diabetes results in microvascular alterations in the brain, skeletal muscle and myocardium that can be prevented by chronic blockade of the renin-angiotensin system. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Proteasome Modulator 9 SNPs are linked to hypertension in type 2 diabetes families

    Directory of Open Access Journals (Sweden)

    Gragnoli Claudia

    2011-08-01

    Full Text Available Abstract Background Chromosome 12q24 was recently associated with hypertension. Proteasome Modulator 9 (PSMD9 lies in the 12q24 locus and is in linkage with MODY3, type 2 diabetes (T2D, microvascular and macrovascular pathology, carpal tunnel syndrome, and hypercholesterolemia in Italian families. Aims Our goal was to determine whether PSMD9 is linked to elevated blood pressure/hypertension in T2D families. Methods We characterized the Italian T2D families' members for presence and/or absence of elevated blood pressure (≥ 130/80 and/or hypertension. The phenotypes were described as unknown in all cases in which the diagnosis was either unclear or the data were not available for the subject studied. We tested in the 200 Italians families for the presence of the linkage of the PSMD9 T2D risk single nucleotide polymorphisms (SNPs IVS3+nt460 A > G, IVS3+nt437 T > C and E197G A > G with elevated blood pressure/hypertension. The non-parametric linkage analysis was performed for this qualitative phenotype by using the Merlin software; the Lod score and correspondent P-value were calculated. Parametric linkage analysis was also performed. For the significant linkage score, 1000 replicates were run to calculate the empirical P-value. Results The PSMD9 gene SNPs studied are in linkage with elevated blood pressure/hypertension in our Italian families. Conclusions We conclude that the PSMD9 gene and/or any variant in linkage disequilibrium with the SNPs studied contribute to the linkage to hypertension within our family dataset. This is the first report of PSMD9 linkage to hypertension within the 12q24 locus.

  8. Menstruationsforstyrrelser ved insulinkraevende diabetes mellitus--epidemiologi og årsager

    DEFF Research Database (Denmark)

    Støving, R K; Hangaard, J; Pedersen, K K

    1994-01-01

    About 20% of all women with insulin-dependent diabetes mellitus (IDDM) have menstrual irregularities. Eight percent have amenorrhea. Fluctuations in blood glucose and insulin concentration are probably contributing factors, but the irregular menstrual cycles are mainly caused by disorders in the ...

  9. Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study

    Science.gov (United States)

    Meme, Nkatha; Amwayi, Samuel; Nganga, Ziporrah; Buregyeya, Esther

    2015-01-01

    Introduction Hypertension (HTN) and diabetes mellitus (DM) are two common non-communicable diseases (NCDs) that are closely linked: one cannot be properly managed without attention to the other. The aim of this study was to determine the prevalence of undiagnosed diabetic and pre-diabetic states that is abnormal glucose regulation (AGR) and factors associated with it among hypertensive patients in Kiambu Hospital, Kenya. Methods We conducted a cross-sectional study from February 2014 to April 2014. Hypertensive patients aged ≥18 attending the out-patient medical clinic were included in the study. Pregnant and known diabetic patients were excluded. Data was collected on socio-demographics, behavior, and anthropometrics. Diabetes status was based on a Glycated Haemoglobin (HbA1C) classification of ≥6.5% for diabetes, 6.0-6.4% for pre-diabetes and ≤6.0% for normal. AGR was the dependable variable and included two diabetic categories; diabetes and pre-diabetes. Results We enrolled 334 patients into the study: the mean age was 59 years (Standard deviation= 14.3). Of these patients 254 (76%) were women. Thirty two percent (107/334; 32%) were found to have AGR, with 14% (46) having un-diagnosed DM and 18%(61) with pre-diabetes. Factors associated with AGR were age ≥45 (OR = 3.23; 95% CI 1.37 ≥ 7.62), basal metabolic index (BMI) ≥ 25 Kg/m2 (OR= 3.13; 95% CI 1.53 - 6.41), low formal education (primary/none)(OR= 2; 95%CI 1.08 - 3.56) and family history of DM (OR = 2.19; 95%CI 1.16 - 4.15). Conclusion There was a high prevalence of undiagnosed AGR among hypertensive patients. This highlights the need to regularly screen for AGR among hypertensive patients as recommended by WHO. PMID:26966482

  10. Carvedilol versus cardioselective beta-blockers for the treatment of hypertension in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Fardoun, Riham Zein

    2006-10-01

    Treatment with beta-blockers is recommended to achieve and maintain adequate blood pressure control in patients with hypertension, and these agents have been shown to decrease cardiovascular risk factors in patients with both hypertension and type 2 diabetes mellitus. However, beta-blocker therapy also may worsen glycemic and lipidemic control and may lead to microalbuminuria. A recent study showed a better metabolic profile with carvedilol than with metoprolol in patients with both type 2 diabetes and hypertension in the presence of renin-angiotensin system blockade. This beneficial effect on metabolic components has been proposed as attributable to carvedilol's alpha-blocking effects or antioxidant properties. In this article, the pathophysiology of hypertension and type 2 diabetes and the association between them are reviewed, the pharmacologic properties of carvedilol are discussed, and clinical studies in the literature comparing carvedilol with selective beta-blockers in patients with both type 2 diabetes and hypertension are identified and evaluated. This information should be useful to practitioners when selecting the optimum beta-blocker for treating hypertension in patients with type 2 diabetes.

  11. Food habits of hypertensive and diabetics cared for in a Primary Health Care service in the South of Brazil

    Directory of Open Access Journals (Sweden)

    Lena Azeredo de Lima

    2015-04-01

    Full Text Available OBJECTIVE: Describe the eating habits of hypertensive and diabetic individuals, classify their adequacy according to the Ministry of Health's Food Guide for the Brazilian Population and determine the association between adequate diet and the health problems under investigation. METHODS: Descriptive study from the baseline of a longitudinal study begun in 2011, with a sample of hypertensive and diabetic patients from a Primary Health Care facility in Southern Brazil, interviewed at home. RESULTS: A total of 2,482 people were interviewed, of which 66.5% were hypertensive, 6.5% diabetic and 27.1% suffered from hypertension and diabetes. Of those interviewed, 29.6% had inadequate eating habits, 46.9% partially inadequate and 23.4% had adequate diets. Low fiber intake was identified along with high consumption of soda, sugar, salt and saturated fat. The most adequate diet was associated with poor health status and the prevalence of inadequate diet was 30.0% higher among those who were only hypertensive. CONCLUSION: According to Ministry of Health guidelines, the eating habits of diabetic and hypertensive subjects are inadequate. The association between adequate diet and the health problems studied indicated a delayed improvement in diet, suggesting an urgent need for preventive and effective interventions to promote healthy eating.

  12. System of matrix metalloproteinases and cytokine secretion in type 2 diabetes mellitus and impaired carbohydrate tolerance associated with arterial hypertension.

    Science.gov (United States)

    Kologrivova, I V; Suslova, T E; Koshel'skaya, O A; Vinnitskaya, I V; Trubacheva, O A

    2014-03-01

    The study included patients with type 2 diabetes mellitus and impaired carbohydrate tolerance associated with arterial hypertension, patients with arterial hypertension, and healthy volunteers. We evaluated the levels of matrix metalloproteinases 2 and 9 (MMP-2, MMP-9), tissue inhibitor of metalloproteinase type 1 (TIMP-1), glucose, insulin, C-peptide, glycated hemoglobin, and spontaneous and mitogen-activated cytokine secretion (IL-2, IL4, IL-6, IL-10, IL-17, TNF-α, and IFN-γ). Patients with type 2 diabetes mellitus in combination with arterial hypertension exhibited maximum TIMP-1 levels and TIMP-1/MMP-2, TIMP-1/ MMP-9 ratios as well as enhanced secretion of TNF-α, IL-6, IL-17 and reduced secretion of IL-10 in comparison with healthy individuals. The observed shifts are probably determined the development of systemic hyperinsulinemia in patients suffering from type 2 diabetes mellitus coupled with arterial hypertension.

  13. A study on anti-diabetic and anti-hypertension herbs used in Lorestan province, Iran

    Directory of Open Access Journals (Sweden)

    Delfan Bahram

    2014-04-01

    Full Text Available Introduction: Diabetes and hypertension are amongst the most prevalent diseases in the world, while they can be controlled and prevented, create many problems and complications for affected patients. This study was aimed to identify and report the most important and effective herbs for diabetes and high blood pressure treatment in Lorestan province (West of Iran. Methods: By gathering and integrating indigenous data from local inhabitants of Lorestan, Iran, the goal of this study was accomplished. Data were gathered by cooperation of the agents of public health services network all over the towns of Dorud, Boroujerd, Khorramabad, Aleshtar, Poledokhtar, Aligoodarz, Nurabad and Kouhdasht. Results: Results of this study showed that there were overall 17 medicinal plants which were used for treatment and controlling of diabetes and high blood pressure. Conclusion: Medicinal plants reported in this study are indigenous to the Lorestan province. Some of the foresaid herbs seem to have some unknown therapeutic effects which are reported in this study for the first time, and some others have various known therapeutic effects mentioned in other similar studies. It is essential for researchers to find out the actuality of clinical effectiveness of the herbs and their active substances. Once the positive effects of these herbs proved, it would be possible to produce drugs which are useful in curing and controlling diabetes and hypertension.

  14. Behavior risk factors and lipid profiles of diabetes mellitus with hypertension among adult population in Indonesia

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    Nunik Kusumawardani

    2016-12-01

    Full Text Available Latar belakang: Penyakit Diabetes Mellitus (DM yang disertai dengan Hipertensi dapat meningkatkan risiko terjadinya disabilitas dan kematian premature. Data besaran masalah DM yang disertai Hipertensi masih terbatas pada data dari fasilitas kesehatan sementara data berbasis populasi merupakan informasi penting untuk memberikan gambaran besaran masalah secara nasional di masyarakat. Studi ini bertujuan untuk mendapatkan gambaran besaran masalah DM dengan disertai Hipertensi serta hubungannya dengan faktor risiko PTM lainnya berdasarkan data RISKESDAS 2013 yang mencakup 34 Provinsi di Indonesia. Metode: Studi Ini merupakan analisis data sekunder dari RISKESDAS 2013. Data dikumpulkan menggunakan kuesioner terstruktur dan pengukuran tekanan darah dan pemeriksaan darah. Jumlah sampel yang dianalisis adalah 35, 931 individu usia 18 tahun ke atas. Pemilihan sampel dengan cara “four stages stratified sampling method”. Hasil: Hasil analisis menunjukkan bahwa prevalensi DM dengan disertai Hipertensi adalah sebesar 3,0%, dengan prevalensi tertinggi sebesar 14% pada laki-laki dan 8% pada perempuan. DM dan hipertensi mempunyai hubungan yang bermakna dengan indeks merokok (OR:2,94 pada laki-laki, dengan obesitas (OR: 2,35 pada laki-laki dan 2,19 pada perempuan, dan dengan kolesterol darah (OR: 1,86 pada laki-laki dan 3,45 pada perempuan. Kesimpulan: Beberapa faktor risiko seperti indeks masa tubuh, profil lemak, konsumsi buah dan sayuran serta merokok dapat dijadikan indikator untuk pencegahan penyakit komplikasi DM dan hipertensi, risiko disabilitas dan kematian prematur. (Health Science Journal of Indonesia 2016;7(2:97-106 Kata Kunci: diabetes mellitus, hipertensi, faktor risiko perilaku Abstract Background: Diabetes mellitus (DM with hypertension increases risk of disability and premature death. Data on DM with hypertension is limited to hospital based data, while population-based data is important to provide problem magnitude in the population

  15. The Prevalence of Pre-hypertension in Children with Type 1 Diabetes Mellitus

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    Farzaneh Rohani

    2014-01-01

    Full Text Available Background: Hypertension is more common in adults with type 1 diabetes mellitus (T1DM than the general population. The aim of this study was to detect the pre-hypertensive stage in children with T1D and to evaluate its correlation with diabetic nephropathy compared to non-diabetic children. Methods: This was a prospective cross-sectional study in an out-patient clinic of a university hospital. A total of 62 which consists of 36 males and 26 females patients with stable T1D with a median age of 13 year and 42 age - sex-matched healthy children were entered in the study between September 2008 and February 2011. Three readings of blood pressure were recorded. Fasting blood sample was drawn for hemoglobin A1C (HbA 1 C, creatinine and a 24 h urine aliquot was collected to measure microalbumin, creatinine and volume to estimate glomerular filtration rate (eGFR. Results: From 62 children with T1DM, 25.8% were in pre-hypertensive stage, 4.8% Stage 1, and 1.6% Stage 2. In controls, 1 (2.4% out of 42 children was in pre-hypertensive stage (P < 0.0001. Abnormal blood pressures were correlated with eGFR and the duration of disease (P < 0.05, but there were not associated with microalbominuria or HbA 1 C level. Conclusions: There was a higher rate of early stage of high normal blood pressure in children with T1DM compared with the healthy controls and this abnormality was only correlated with puberty stage and glomerular filtration rate.

  16. Association of obesity and treated hypertension and diabetes with cognitive ability in bipolar disorder and schizophrenia.

    Science.gov (United States)

    Depp, Colin A; Strassnig, Martin; Mausbach, Brent T; Bowie, Christopher R; Wolyniec, Paula; Thornquist, Mary H; Luke, James R; McGrath, John A; Pulver, Ann E; Patterson, Thomas L; Harvey, Philip D

    2014-06-01

    People with bipolar disorder or schizophrenia are at greater risk for obesity and other cardio-metabolic risk factors, and several prior studies have linked these risk factors to poorer cognitive ability. In a large ethnically homogenous outpatient sample, we examined associations among variables related to obesity, treated hypertension and/or diabetes and cognitive abilities in these two patient populations. In a study cohort of outpatients with either bipolar disorder (n = 341) or schizophrenia (n = 417), we investigated the association of self-reported body mass index and current use of medications for hypertension or diabetes with performance on a comprehensive neurocognitive battery. We examined sociodemographic and clinical factors as potential covariates. Patients with bipolar disorder were less likely to be overweight or obese than patients with schizophrenia, and also less likely to be prescribed medication for hypertension or diabetes. However, obesity and treated hypertension were associated with worse global cognitive ability in bipolar disorder (as well as with poorer performance on individual tests of processing speed, reasoning/problem-solving, and sustained attention), with no such relationships observed in schizophrenia. Obesity was not associated with symptom severity in either group. Although less prevalent in bipolar disorder compared to schizophrenia, obesity was associated with substantially worse cognitive performance in bipolar disorder. This association was independent of symptom severity and not present in schizophrenia. Better understanding of the mechanisms and management of obesity may aid in efforts to preserve cognitive health in bipolar disorder. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Correlates for cardiovascular diseases among diabetic/hypertensive patients attending outreach clinics in two Nairobi slums, Kenya.

    Science.gov (United States)

    Mugure, Gladys; Karama, Mohamed; Kyobutungi, Catherine; Karanja, Simon

    2014-01-01

    Cardiovascular diseases (CVD) are the leading cause of death in the world. Over 80% of CVD related deaths occur in low- and middle-income countries (LMICs). Diabetes and hypertension, whose prevalence in Kenya is on the rise, are major risk factors for CVD. Despite this, studies indicate that awareness on the management of risk factors for CVD among diabetic/hypertensive patients in African populations is generally low. The aim of the study was to determine the risk factors for CVD among diabetic and/or hypertensive patients attending diabetes and hypertension management clinics in Korogocho and Viwandani slums of Nairobi. Data were collected using questionnaires administered to 206 diabetic/hypertensive patients attending the clinics between July 2010 and February 2011. A review of these patients' medical records was done to determine the history of CVD outcomes such as hypertensive heart diseases, stroke and peripheral arterial diseases. Majority (66.5%) of the study participants were females mainly in the 51-65 age category. The study findings revealed that 73 (33.4%) respondents had CVD outcomes. In addition, 41.8% of the respondents were not aware of the causes of diabetes/hypertension. Age category 51-65 years had the highest (43.8%) number of respondents with CVD. Sex of the respondents and awareness of the link between hypertension and CVD were significantly associated with CVD outcomes (p<0.05) among the respondents. Measures to improve awareness levels among patients at high risk of CVD outcomes are needed to complement other measures to reduce CVD risk among such patients.

  18. Tidlig introduksjon av kumelk i spedbarnsalder og risiko for type 1 diabetes

    OpenAIRE

    Stølen, Ole Andreas

    2014-01-01

    Background: Several different factors point to the significance of the role of non-genetic causes in the etiology of type 1 diabetes. Some studies have suggested a positive correlation between early exposure to cow s milk in infancy and increased later risk of developing the disease, while other studies have not found such a correlation. The issue is still unresolved, and in this systematic review I will investigate the most relevant literature on the subject. Methods: I conducted a systemati...

  19. Smoking, diabetes, blood hypertension: possible etiologic role for Peyronie’s disease? Analysis in 279 patients with a control group in Sicily

    National Research Council Canada - National Science Library

    Pavone, Carlo; D’Amato, Francesco; Dispensa, Nino; Torretta, Federico; Magno, Carlo

    2015-01-01

    ...), the second one composed by patients with other andrological diseases (control arm). For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function...

  20. Differences in circadian time structure of diastolic blood pressure between diabetes mellitus and essential hypertension

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    Matteucci Elena

    2012-12-01

    Full Text Available Abstract Background Abnormal circadian blood pressure patterns have been associated with cardiovascular disease in diabetes mellitus. We have described that the acrophase of diastolic blood pressure (DBP registered in type 1 diabetes (T1D patients was significantly earlier than normal and DBP ecphasia was more pronounced in patients with lower heart rate variability during deep breathing. The aim of this study was to compare the circadian rhythm characteristics of BP among different groups: normotensive (NT control subjects, patients affected by T1D and type 2 diabetes (T2D, and patients with essential hypertension (HT. Findings We retrospectively evaluated ambulatory blood pressure monitoring records in 30 NT, 20 T1D, 20 T2D, 20 HT whose fasting plasma glucose and HbA1c were contemporaneously measured. The four groups were well-matched regarding age, gender, and BMI. Systolic blood pressure (SBP and DBP midline-estimating statistic of rhythm were higher in T1D, T2D, and HT groups. DBP ecphasia was present only in the diabetic individuals: the acrophase of DBP occurred four hours earlier than normal in T1D group, whereas two hours earlier in T2D group. In a multiple regression analysis, only HbA1c and SBP acrophase were statistically significant correlates of DBP acrophase. Conclusions People with diabetes mellitus, both type 1 and type 2, have their circadian acrophase of DBP occurring 2–4 hours earlier than normotensive and hypertensive subjects. Altered circadian timing of DBP, potential trigger of cardiovascular events, seems to be a distinguishing feature of diabetes mellitus and correlates with the previous 2–3 months of glycaemic control.

  1. Predictors of cardiac morbidity in diabetic, new-onset diabetic and non-diabetic high-risk hypertensive patients: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial.

    Science.gov (United States)

    Aksnes, Tonje A; Kjeldsen, Sverre E; Rostrup, Morten; Holzhauer, Björn; Hua, Tsushung A; Julius, Stevo

    2016-08-01

    Diabetic and new-onset diabetic patients with hypertension have higher cardiac morbidity than patients without diabetes. We aimed to investigate whether baseline predictors of cardiac morbidity, the major constituent of the primary endpoint in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, were different in patients with diabetes and new-onset diabetes compared to patients without diabetes. In total, 15,245 high-risk hypertensive patients in the VALUE trial were followed for an average of 4.2 years. At baseline, 5250 patients were diabetic by the 1999 World Health Organization criteria, 1298 patients developed new-onset diabetes and 8697 patients stayed non-diabetic during follow-up. Cardiac morbidity was defined as a composite of myocardial infarction and heart failure requiring hospitalization, and baseline predictors were identified by univariate and multivariate stepwise Cox regression analyses. History of coronary heart disease (CHD) and age were the most important predictors of cardiac morbidity in both diabetic and non-diabetic patients. History of CHD, history of stroke and age were the only significant predictors of cardiac morbidity in patients with new-onset diabetes. Predictors of cardiac morbidity, in particular history of CHD and age, were essentially the same in high-risk hypertensive patients with diabetes, new-onset diabetes and without diabetes who participated in the VALUE trial.

  2. Low-dose spironolactone reduces plasma fibulin-1 levels in patients with type 2 diabetes and resistant hypertension

    DEFF Research Database (Denmark)

    Stolzenburg Oxlund, Christina; Cangemi, Claudia; Henriksen, J E

    2015-01-01

    Diabetic patients with hypertension are at particularly high risk of vascular damage and consequently cardiovascular and renal disease. Fibulin-1, an extracellular matrix glycoprotein, is increased in arterial tissue and plasma from individuals with type 2 diabetes. This study aimed to evaluate...... whether antihypertensive treatment with spironolactone changes plasma fibulin-1 levels. In a multicenter, double-blind, randomized, placebo-controlled study, 119 patients with type 2 diabetes and resistant hypertension were included. A dose of spironolactone 25 mg or matching placebo was added to previous....... Treatment with low-dose spironolactone reduced plasma fibulin-1 levels in patients with type 2 diabetes and resistant hypertension. This supports the hypothesis that the antihypertensive effect of the mineralocorticoid receptor blocker in part may be due to regression of vascular remodeling....

  3. The role of hypertension in the development of nephropathy in type 1 (insulin-dependent) diabetes mellitus

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B; Nørgaard, K; Jensen, T

    1990-01-01

    Which comes first when developing clinical diabetic nephropathy, the blood pressure rise or the increasing urinary albumin excretion? This issue is discussed based on recent literature of studies in humans with Type 1 (insulin-dependent) diabetes mellitus. We conclude that hypertension has...... a central role in the progression of diabetic nephropathy and has deleterious effects on the life expectancy of patients who already have signs of diabetic renal disease in terms of elevated urinary albumin excretion. However, blood pressure is preceded by small increments of urinary albumin excretion rates......, an indicator of universally increased vascular leakiness, and thus does not seem to be the cause of diabetic nephropathy....

  4. [Microalbuminuria and left ventricular hypertrophy in essential arterial hypertension. A study in non-diabetic patients].

    Science.gov (United States)

    Berrut, G; Chameau, A M; Bouhanick, B; Page, J D; Hallab, M; Richard, C; Girault, A; Fressinaud, P; Marre, M

    To evaluate the relationship between urinary albumin excretion and left ventricular hypertrophy in essential hypertension, we studied, cross-sectionally, 64 subjects with essential hypertension and no diabetes. Urinary albumin excretion and Sokolow index correlated significantly (r = 0.483; P = 0.0001). Five subjects were positive for microalbuminuria (> 30 mg/24 h) and Sokolow index (> 35 mm); 43 were negative for both, with a concordance rate of 77 percent (chi-squared test 11.1; P = 0.0009). Stepwise multivariate regression analysis indicated two independent determinants for urinary albumin excretion: Sokolow index (F = 18.29), and diastolic blood pressure (F = 12.23). The relationships between urinary albumin excretion, Sokolow index, and blood pressure were not different in the 18 subjects taking angiotensin I-converting enzyme inhibitors and in the 46 others. The close relationship between urinary albumin excretion and Sokolow index observed in this study suggests that left ventricular hypertrophy due to hypertension may account for the increased cardiovascular mortality observed in non diabetic subjects with microalbuminuria.

  5. Mannanbindende lektin og mortalitet hos patienter med type 2-diabetes--sekundaerpublikation

    DEFF Research Database (Denmark)

    Hansen, Troels Krarup; Gall, Mari-Anne; Tarnow, Lise

    2009-01-01

    We evaluated the relationship between serum mannose-binding lectin (MBL) and mortality and incident albuminuria in 326 patients with type 2 diabetes mellitus (T2DM). During 15 years of follow-up, 169 patients died. In a multivariate analysis, MBL was a significant risk factor for death from any...... cause and added to the predictive power of CRP. Normoalbuminuric patients with both high MBL and high C-reactive protein (CRP) levels had a significantly increased risk of developing albuminuria. We conclude that MBL alone or in combination with CRP can provide prognostic information on mortality...

  6. Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes

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    Nakamura M

    2014-05-01

    Full Text Available Makiko Nakamura,1 Nobuo Sasai,2 Ichiro Hisatome,3 Kimiyoshi Ichida11Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 2Sasai Clinic, Kanagawa, Japan; 3Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Tottori, JapanBackground: Hyperuricemia has been proposed to be a risk factor for cardiovascular disease and chronic kidney disease. Since diabetes is often complicated by hypertension and hyperuricemia, efficient therapeutic strategy against these two complications is very important in diabetic treatment. It has been reported that the antihypertensive drug, irbesartan, inhibits the renal uric acid reabsorptive transporters, URAT1 and GLUT9; this result suggests that irbesartan decreases serum uric acid level (SUA.Subjects and methods: A retrospective study of 107 patients with hypertension and diabetes was performed to analyze the effects of irbesartan on blood pressure, estimated glomerular filtration rate (eGFR, and SUA. The follow-up period was 6–12 months. Seventy percent of the patients were diagnosed with diabetic nephropathy stage II–IV. We excluded patients treated with drugs that influenced SUA. The multiple logistic regression analysis was introduced to identify the relative factors for SUA decline. The time-dependent SUA changes were examined in a mixed-linear model.Results: Irbesartan reduced blood pressure significantly after 1, 6, and 12 months’ treatment. No subject showed significant change in eGFR from baseline level throughout the period. The multiple logistic regression analysis revealed that SUA baseline significantly influenced SUA decline after 6–12 months. In patients whose SUA baseline was ≥5.9 mg/dL, the SUA was significantly decreased from 6.6±0.16 mg/dL to 6.2±0.16 mg/dL (P=0.010, after 12 months’ irbesartan treatment. In the SUA baseline <5.9 mg/dL group

  7. [Chronic complications, hypertension and obesity in diabetic patients living in Cartagena, Colombia].

    Science.gov (United States)

    Alayón, Alicia N; Altamar-López, Diana; Banquez-Buelvas, Clara; Barrios-López, Karen

    2009-12-01

    Identifying the presence of chronic complications and evaluating obesity and hypertension control in diabetic patients taking part in a control and monitoring programme in Cartagena, Colombia. This was a descriptive cross-sectional study which reviewed 499 medical records from a basic health care unit in Cartagena during 2006. Sociodemographic data (age and sex) and other information concerning disease stage, hypertension, obesity, chronic complications and attending control appointments were collected using a structured form. 161 (32%) of the patients had chronic complications, the most frequently occurring being neuropathy (41%) and nephropathy (29%). More complications were found in older patients. Neuropathy predominated in women (48.1%) and nephropathy in men (45.6%); 80% of the patients were suffering from hypertension. There was no significant difference between those who had complications and those who did not (83.2 % and 77.2%, respectively). Only 29% of the patients had normal weight, the rest were obese (31%) or overweight (40%). Patients with complications attended control appointments less frequently. Body weight control strategies must be strengthened, as must hypertension and foot care strategies. An active search for retinopathy must be made to postpone or prevent the onset of chronic complications.

  8. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study

    Science.gov (United States)

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-ichi; Takishita, Shu-ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-01-01

    Objectives Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Design Multicentre, unblinded, pragmatic, randomised, controlled trial with blinded assessment of end points and intention-to-treat analysis that was started in 2004 and finished in 2012. Setting Hypertension clinics at 106 sites in Japan, including general practitioners’ offices and teaching hospitals. Participants Non-diabetic patients with essential hypertension. Interventions Antihypertensive treatment with low-dose thiazide diuretics at 12.5 mg/day of hydrochlorothiazide or equivalent (Diuretics group) or that without thiazide diuretics (No-diuretics group). Main outcome The primary outcome was new onset of type 2 diabetes diagnosed according to WHO criteria and the criteria of Japanese Society of Diabetes. Results 1130 patients were allocated to Diuretics (n=544) or No-diuretics group (n=586). Complete end point information was collected for 1049 participants after a median follow-up of 4.4 years. Diabetes developed in 25 (4.6%) participants in the Diuretics group, as compared with 29 (4.9%) in the No-diuretics group (HR 0.93; 95% CI 0.55 to 1.58; p=0.800). Conclusions Antihypertensive treatment with thiazide diuretics at low doses may not be associated with an increased risk for new onset of type 2 diabetes. This result might suggest safety of use of low doses of thiazide diuretics. Trial registration number ClinicalTrials.gov NCT00131846. PMID:25031188

  9. Oleuropein improves glucose tolerance and lipid profile in rats with simultaneous renovascular hypertension and type 2 diabetes.

    Science.gov (United States)

    Khalili, Azadeh; Nekooeian, Ali Akbar; Khosravi, Mohammad Bagher

    2017-10-01

    Oleuropein mediates most of the beneficial effects of olive products. This study examined the role of oxidative stress in the effects of oleuropein on lipid profile and blood glucose in rats with simultaneous renovascular hypertension and type 2 diabetes. Eight groups (n = 7-9 each) of male Sprague-Dawley rats including a control, a type 2 diabetic, a renovascular hypertensive, a sham, a simultaneously hypertensive diabetic receiving vehicle, and 3 simultaneously hypertensive-diabetic receiving 20, 40, or 60 mg/kg/day oleuropein were used. Four weeks after treatment, blood glucose, lipid profile, and biomarkers of oxidative stress were measured, and glucose tolerance test (GTT) was performed. Simultaneously hypertensive diabetic rats had significantly higher blood pressure, blood glucose, and serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglyceride and malondialdehyde. They also had lower serum high-density lipoprotein cholesterol, erythrocyte superoxide dismutase, and impaired glucose tolerance. Oleuropein significantly reduced blood pressure, blood glucose, and serum total cholesterol, LDL-C, triglyceride and malondoaldehyde. It also increased serum high-density lipoprotein cholesterol, erythrocyte superoxide dismutase, and improved glucose tolerance. The findings show that the model is associated with impaired glucose tolerance, and adverse lipid profile. They also show that oleuropein, partly by an antioxidant mechanism, improves glucose tolerance and changed lipid profile favorably.

  10. Diabetes and hypertension increase the placental and transcellular permeation of the lipophilic drug diazepam in pregnant women

    Science.gov (United States)

    2013-01-01

    Background Previous studies carried out in our laboratories have demonstrated impaired drug permeation in diabetic animals. In this study the permeation of diazepam (after a single dose of 5 mg/day, administered intramuscularly) will be investigated in diabetic and hypertensive pregnant women. Methods A total 75 pregnant women were divided into three groups: group 1 (healthy control, n = 31), group 2 (diabetic, n = 14) and group 3 (hypertensive, n = 30). Two sets of diazepam plasma concentrations were collected and measured (after the administration of the same dose of diazepam), before, during and after delivery. The first set of blood samples was taken from the mother (maternal venous plasma). The second set of samples was taken from the fetus (fetal umbilical venous and arterial plasma). In order to assess the effect of diabetes and hypertension on diazepam placental-permeation, the ratios of fetal to maternal blood concentrations were determined. Differences were considered statistically significant if p ≤ 0.05. Results The diabetes and hypertension groups have 2-fold increase in the fetal umbilical-venous concentrations, compared to the maternal venous concentrations. Feto: maternal plasma-concentrations ratios were higher in diabetes (2.01 ± 1.10) and hypertension (2.26 ± 1.23) groups compared with control (1.30 ± 0.48) while, there was no difference in ratios between the diabetes and hypertension groups. Umbilical-cord arterial: venous ratios (within each group) were similar among all groups (control: 0.97 ± 0.32; hypertension: 1.08 ± 0.60 and diabetes: 1.02 ± 0.77). Conclusions On line with our previous findings which demonstrate disturbed transcellular trafficking of lipophilic drugs in diabetes, this study shows significant increase in diazepam placental-permeation in diabetic and hypertensive pregnant women suggesting poor transcellular control of drug permeation and flux, and bigger exposure of the fetus

  11. The Improvement of Hypertension by Probiotics: Effects on Cholesterol, Diabetes, Renin, and Phytoestrogens

    Directory of Open Access Journals (Sweden)

    Huey-Shi Lye

    2009-08-01

    Full Text Available Probiotics are live organisms that are primarily used to improve gastrointestinal disorders such as diarrhea, irritable bowel syndrome, constipation, lactose intolerance, and to inhibit the excessive proliferation of pathogenic intestinal bacteria. However, recent studies have suggested that probiotics could have beneficial effects beyond gastrointestinal health, as they were found to improve certain metabolic disorders such as hypertension. Hypertension is caused by various factors and the predominant causes include an increase in cholesterol levels, incidence of diabetes, inconsistent modulation of renin and imbalanced sexual hormones. This review discusses the antihypertensive roles of probiotics via the improvement and/or treatment of lipid profiles, modulation of insulin resistance and sensitivity, the modulation of renin levels and also the conversion of bioactive phytoestrogens as an alternative replacement of sexual hormones such as estrogen and progesterone.

  12. The association between hypertension and diabetes in a Family Health Center - doi:10.5020/18061230.2011.p16

    Directory of Open Access Journals (Sweden)

    Daniele Braz da Silva

    2012-01-01

    Full Text Available Objective: To describe the clinical characteristics of patients with hypertension treated in a health unit and its association with diabetes, relating to sex and age. Methods: We conducted this quantitative and documentary research with 297 registered users in the Plan of Reorganization of Care for Hypertension and Diabetes Mellitus (HIPERDIA / MS of a Family Health Center of the Regional Executive Office VI (SER VI at Fortaleza -Ceará, in May 2009. The sample was divided according to gender, age and relationship between hypertension and diabetes. Results: We found a predominance of women, over 40 years, with hypertension and without diabetes. Fifty-eight (19.5% users had hypertension and diabetes associated, suggesting an additional risk factor, relevant to this clientele. One hundred and fifty-five (52.2% of hypertensive patients, with and without diabetes, controlled blood pressure and among those who were not in control, 85 (28.6% were elderly. It was identified that 46 (15.5% users were affected by some complication, especially the stroke as the most prevalent among female 13 (52% and acute myocardial infarction in male 11 (38%. The antihypertensive drugs and hypoglycemic most used were 170 (71.1% hydrochlorothiazide, 44 (75.9% glibenclamide and 04 (6.9% insulin. Conclusion: High blood pressure affects men and women, and its prevalence increases with age. When associated with diabetes, increases the risk of developing cardiovascular disease. It is believed that the education of individuals with chronic illness is the best way to reduce these harms.

  13. Trends in hypertension prevalence, awareness, treatment and control in an adult type 2 diabetes Spanish population between 2003 and 2009.

    Directory of Open Access Journals (Sweden)

    Carmen de Burgos-Lunar

    Full Text Available In patients with type 2 diabetes, the prevalence of hypertension is higher than in non-diabetic subjects. Despite the high cardiovascular risk involving hypertension in these patients, its prevalence and control are not well known. The aims of this study were: to estimate the hypertension prevalence, awareness, treatment and control in Spanish adults with type 2 diabetes attended in Primary Care; and to analyse its time trend from 2003 to 2009. A serial cross-sectional study from 2003 to 2009 was performed in 21 Primary Care Centres in Madrid. The study population comprised all patients with diagnosed type 2 diabetes in their computerised medical history. Overall annual prevalence during the period 2003-2009 was calculated from and according to sex and age groups. Linear trend tests, regression lines and coefficients of determination were used. In 2003 89.78% (CI 87.92-91.64 of patients with type 2 diabetes suffered hypertension and 94.76% (CI: 92.85-96.67 in 2009. This percentage was greater for women and for patients over 65 years old. 30% of patients suffered previously undiagnosed hypertension in 2003 and 23.1% in 2009. 97% of diagnosed patients received pharmacological treatment and 28.79% reached the blood pressure objective in 2009. The average number of antihypertensive drugs taken was 2.72 in 2003 and 3.27 in 2009. Only 5.2% of patients with type 2 diabetes show blood pressure levels below 130/80 mmHg. Although significant improvements have been achieved in the diagnosis and control of hypertension in people with type 2 diabetes, these continue to remain far from optimum.

  14. Apocynin influence on oxidative stress and cardiac remodeling of spontaneously hypertensive rats with diabetes mellitus.

    Science.gov (United States)

    Rosa, C M; Gimenes, R; Campos, D H S; Guirado, G N; Gimenes, C; Fernandes, A A H; Cicogna, A C; Queiroz, R M; Falcão-Pires, I; Miranda-Silva, D; Rodrigues, P; Laurindo, F R; Fernandes, D C; Correa, C R; Okoshi, M P; Okoshi, K

    2016-09-01

    Although increased oxidative stress is a major component of diabetic hypertensive cardiomyopathy, research into the effects of antioxidants on cardiac remodeling remains scarce. The actions of antioxidant apocynin include inhibiting reactive oxygen species (ROS) generation by nicotinamide adenine dinucleotide phosphate (NADPH) oxidases and ROS scavenging. We evaluated the effects of apocynin on cardiac remodeling in spontaneously hypertensive rats (SHR) with diabetes mellitus (DM). Male SHR were divided into four groups: control (SHR, n = 16); SHR treated with apocynin (SHR-APO; 16 mg/kg/day, added to drinking water; n = 16); diabetic SHR (SHR-DM, n = 13); and SHR-DM treated with apocynin (SHR-DM-APO, n = 14), for eight weeks. DM was induced by streptozotocin (40 mg/kg, single dose). Statistical analyzes: ANOVA and Tukey or Mann-Whitney. Echocardiogram in diabetic groups showed higher left ventricular and left atrium diameters indexed for body weight, and higher isovolumetric relaxation time than normoglycemic rats; systolic function did not differ between groups. Isolated papillary muscle showed impaired contractile and relaxation function in diabetic groups. Developed tension was lower in SHR-APO than SHR. Myocardial hydroxyproline concentration was higher in SHR-DM than SHR, interstitial collagen fraction was higher in SHR-DM-APO than SHR-APO, and type III collagen protein expression was lower in SHR-DM and SHR-DM-APO than their controls. Type I collagen and lysyl oxidase expression did not differ between groups. Apocynin did not change collagen tissue. Myocardial lipid hydroperoxide concentration was higher in SHR-DM than SHR and SHR-DM-APO. Glutathione peroxidase activity was lower and catalase higher in SHR-DM than SHR. Apocynin attenuated antioxidant enzyme activity changes in SHR-DM-APO. Advanced glycation end-products and NADPH oxidase activity did not differ between groups. Apocynin reduces oxidative stress independently of NADPH oxidase

  15. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease...

  16. The association of age, gender, ethnicity, family history, obesity and hypertension with type 2 diabetes mellitus in Trinidad.

    Science.gov (United States)

    Nayak, B Shivananda; Sobrian, Arianne; Latiff, Khalif; Pope, Danielle; Rampersad, Akash; Lourenço, Kodi; Samuel, Nichole

    2014-01-01

    To assess the impact of risk factors such as age, gender, ethnicity, family history, body mass index (BMI), waist circumference and hypertension, on the development of type 2 diabetes mellitus in the Trinidadian population. A cross-sectional case control study comprised 146 non-diabetics and 147 type 2 diabetics ≥18 years of age, from North Central, South West and Eastern regions of Trinidad. Cross-tabulations revealed a significant difference between type 2-diabetes and age at pdiabetes and family history, ethnicity, waist circumference and hypertension at pdiabetics and type 2 diabetics being, 130.62 (±2.124) and 141.35 (±2.312), respectively. No significant difference was observed between type 2 diabetes and gender and BMI. Age was the most significant risk factor of type 2 diabetes. Therefore it can be concluded that family history, ethnicity, waist circumference and hypertension are more significant risk factors of this disease than BMI and gender in the Trinidadian population. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  17. The role of direct renin inhibitors in the treatment of the hypertensive diabetic patient.

    Science.gov (United States)

    Riccioni, Graziano

    2013-10-01

    Hypertensive patients with diabetes exhibit an increased risk for cardiovascular complications, such as acute coronary syndrome, stroke, heart failure and chronic kidney disease (CKD). These two chronic diseases are linked to a high rate of morbidity and mortality and for this reason it is important for the clinician to recognize the need for effective treatment of hypertension, which can require combination therapy to achieve blood pressure (BP) goals. Direct renin inhibitors (DRIs) may be useful in combination with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) as they provide a more complete blockade of the renin-angiotensin-aldosterone system (RAAS), effectively suppressing residual angiotensin II production and the counter-regulatory increase in plasma renin activity observed in patients receiving monotherapy with ACEIs or ARBs. Some questions regarding the action of aliskiren in cardiovascular and renal disorders are open. In particular, the combination therapy of aliskiren and a RAAS blocker in diabetic hypertensive patients with CKD is controversial. Several published studies demonstrated that aliskiren is suitable for once-daily administration and its antihypertensive effect is comparable or superior to that of other antihypertensive agents at recommended doses, with a good tolerability profile. At the moment the association with ACEIs and ARBs is not recommended in patients with type 2 diabetes mellitus (T2DM) and renal impairment even if a recent published open-label study of low-dose aliskiren (150 mg/daily) in association with ACEIs or ARBs has demonstrated a good tolerability profile without the adverse events found in other studies. This review provides a brief overview of RAAS blocking, in particular the rationale and clinical evidence supporting the use of the DRI aliskiren, in high-risk patients with T2DM.

  18. Obesity and associated type 2 diabetes and hypertension in factory workers of Bangladesh.

    Science.gov (United States)

    Bhowmik, Bishwajit; Afsana, Faria; Ahmed, Tareen; Akhter, Sadeka; Choudhury, Hasan Ali; Rahman, Anisur; Ahmed, Tofail; Mahtab, Hajera; Azad Khan, A K

    2015-09-19

    Recent data suggest that the prevalence of obesity and its associate cardiometabolic risks are increasing in Bangladesh. Published data of obesity in Bangladeshi industry workers is scarce. The purpose of this study was to assess the prevalence of general and central obesity in Bangladeshi factory workers and their associations with diabetes and hypertension. A total of 791 male factory workers aged ≥ 20 years in capital Dhaka city of Bangladesh were investigated in a population-based cross-sectional survey. According to the International Association for the Study of Obesity and the International Obesity Task Force guidelines for Asian population, general obesity was defined as body mass index (BMI) ≥ 25 kg/m(2), central obesity was defined as a waist circumference (WC) of ≥ 90 cm and waist hip ratio (WHR) of ≥ 0.90. Pearson's correlation coefficient and logistic regression analysis were used to observe the association between anthropometric indices (BMI, WC and WHR) and cardiometabolic risk indicators (FBG, 2 hBG, SBP and DBP). The prevalence of overweight (BMI 23-24.9 kg/m(2)) and general obesity (BMI ≥ 25 kg/m(2)) in this study population was 29.8 and 43.5% respectively. Central obesity defined by WC and WHR was 35.3 and 78.3% respectively. Both general and central obesity were found to be significantly associated with diabetes and hypertension in separate logistic regression analyses. The prevalence of general and central obesity in Bangladeshi factory workers was high, and it was associated with diabetes and hypertension.

  19. The results of correction of endothelial dysfunction in type 2 diabetes mellitus in patients with diabetic retinopathy and associated hypertension

    Directory of Open Access Journals (Sweden)

    L. K. Moshetova

    2013-01-01

    Full Text Available Purpose:Studying the dynamics of clinical functional and morphological status of the retina against the metabolic and antiischemic therapy of retinopathy in type 2 diabetes associated with hypertension based on indicators in the tear fluid and serum nitric oxide metabolites.Methods: Following a standard ophthalmologic examination of 50 patients, among which are the two groups are similar in age andsex. The main group (n = 37 with Cd 2, DR and DR I and II hypertension II, III stage, the average age was 62,2±1,2 years, antihypertensive therapy — an ACE inhibitor Prestarium (5 mg. Patients of the group were divided into two subgroups: the first subgroup (n = 19who underwent parabulbarnom Mildronate (10 injections, the second subgroup (n = 18, which the drug was administered intranasally Semaks (20 days. The control group (n = 13 healthy (n = 6, and patients with type 2 diabetes without DR and GB (n = 7. Quantitative determination of the stable NO metabolites was determined in biochemical method samples of serum and lacrimal fluid.Results: After completing a course of therapy for patients of the first subgroup marked decrease in retinal thickness (p ≤ 0,05 in f.centralis, temporal lobe, the upper and lower bands parafovea and temporal area perifovea, while in the second group — in 9 areas of the macular area (p ≤ 0.05. It is also noted a significant increase in sensitivity to light in the macular area in patients of both subgroups (MAIA. On the background of the treatment observed reduction of NOx in the lacrimal fluid and serum of patients in both clinical groups. Thus, reduction of NOx in the lacrimal fluid was statistically significant in the subgroup of patients receiving anti-ischemic therapy semaks (p <0,05. In both clinical subgroups after treatment revealed correlation between systolic blood pressure and the level of NOx in the serum (r = 0,4; p <0,05.Conclusion: The positive effect (p <0,05 antioxidant (Mildronat and

  20. Plasmin in urine from patients with type 2 diabetes and treatment-resistant hypertension activates ENaC in vitro

    DEFF Research Database (Denmark)

    Buhl, Kristian B; Stolzenburg Oxlund, Christina; Friis, Ulla G

    2014-01-01

    diabetes mellitus (T2DM) and treatment-resistant hypertension excrete plasmin(ogen) in urine in proportion to albumin and that plasmin confers to urine the ability to activate ENaC. METHOD:: Patients (n = 113) with T2DM and resistant hypertension, defined as systolic blood pressure (SBP) more than 130 mm...... of plasmin in preurine may inappropriately activate ENaC in patients with type 2 diabetes and microalbuminuria. This may contribute to treatment-resistant hypertension.......BACKGROUND:: Aberrant filtration of plasminogen from plasma and subsequent activation to plasmin in the urinary space may activate proteolytically the epithelial sodium channel, ENaC. In conditions with chronic albuminuria, this may cause hypertension. It was hypothesized that patients with type 2...

  1. Parathyroidectomy Ameliorates Glucose and Blood Pressure Control in a Patient with Primary Hyperparathyroidism, Type 2 Diabetes, and Hypertension

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2015-01-01

    Full Text Available Effect of parathyroidectomy on glucose control and hypertension is controversial. Here, we report a case of a patient with primary hyperparathyroidism, type 2 diabetes mellitus, and hypertension in whom parathyroidectomy ameliorated both glucose control and blood pressure. Once high serum calcium levels were noticed, ultrasonography of neck confirmed a well-defined oval hypoechoic mass posterior to the right lobe of the thyroid, confirmed by scintiscan. Parathyroidectomy resulted in improvement of blood pressure and blood glucose. We could stop insulin and antihypertensive medications. We conclude that in patients with type 2 diabetes with vague complaints like fatigue, body ache, and refractory hypertension, as a part of the diagnostic workup, clinicians should also check serum calcium levels and parathyroid hormone to rule out hyperparathyroidism. Correction of hyperparathyroidism may result in improvement of hypertension and glucose control.

  2. Ferritin in hypertensive and diabetic women before and after bariatric surgery

    OpenAIRE

    Marin, Flavia Andreia [UNESP; Rasera Junior, Irineu [UNESP; Souza Leite, Celso Vieira de [UNESP; Marques de Oliveira, Maria Rita [UNESP

    2015-01-01

    In addition to its important role as marker of iron stores, serum ferritin is a marker of systemic inflammation, and obesity has been associated with chronic inflammation.Objective: To verify, six months after surgery, the effect of bariatric surgery on the serum ferritin of women who were hypertensive, diabetic, or comorbidity free before surgery.Sample and methods: This retrospective study included 200 women aged 20 to 45 years, with a body mass index (BMI) equal to or greater than 35 kg/m(...

  3. Characteristics of government workers and association with diabetes and hypertension in the Cook Islands

    Science.gov (United States)

    Kool, B.; Harries, A. D.; Bissell, K.; Gounder, S.; Hill, P. C.; Avare, T.; Fariu, R.

    2014-01-01

    Setting: Twenty government departments in Rarotonga, Cook Islands. Objective: To determine the characteristics, presence of selected non-communicable disease (NCD) risk factors and prevalence of diabetes mellitus (DM) and hypertension among government workers who participated in ‘wellness checks’ in 2012. Design: Cross-sectional study involving analysis of survey data. Results: Of 598 employees, 70% were aged 25–54 years and 55% were female. Two thirds were obese (body mass index ⩾30 kg/m2), and 76% had low levels of fruit and vegetable consumption. Of 50 (8.4%) participants diagnosed with DM (random blood glucose ⩾11 mmol/l, fasting ⩾7 mmol/l), 30 were self-reported and 20 were based on blood glucose. Of the 206 (34.4%) diagnosed with hypertension (systolic ⩾140 and/or diastolic ⩾90), 71 were self-reported and 135 were based on blood pressure measurements. Obesity was associated with hypertension (OR 2.79, 95%CI 1.4–5.4), but not with DM. No relationship was observed between fruit and vegetable consumption and presence or absence of DM or hypertension. Conclusion: This study identified a high prevalence of obesity and hypertension among government employees in the Cook Islands, risk factors that are associated with NCDs such as DM and cardiovascular disease. ‘Wellness checks’ pave the way for interventions in workplace settings to prevent and better manage these diseases through early diagnosis, risk management, treatment and supportive public health policies. PMID:26477285

  4. Cognitive impairment in diabetes mellitus and hypertension, a possibility of correction

    Directory of Open Access Journals (Sweden)

    I. Ch. Khairullin

    2016-01-01

    Full Text Available Objective: to evaluate cognitive functions in patients with type 2 diabetes mellitus (DM2 and hypertension and the efficacy of Ginkgo biloba extract Egb 761®.Patients and methods. 120 patients with DM2 and 50 hypertensive patients with no complications or a history of stroke and/or myocardial infarction, without active complaints of hypomnesia and other cognitive functions were examined. The exclusion criteria were prior stroke and/or myocardial infarction; clinically significant diseases of the peripheral arteries and major arteries of the head; DM2 decompensation; glomerular filtration rate <60 ml/min; proliferative retinopathy; and other endocrine diseases. The investigators used the following methods for the evaluation of cognitive functions: the Mini-Mental State Examination, the Montreal Cognitive Assessment, and the hand- eye coordination test (Parts A and B.Results and discussion. 85% of the patients with DM2 were found to have cognitive impairments (CI: disorders of attention, short-term memory, and thinking speed. Out of them, 82.5% had moderate CI and 2.5% had dementia. 30% of the hypertensive patients were diagnosed as having moderate CIs and 10% had dementia. At the same time, the degree of CI was higher in the patients with MD2 than in those with hypertension. The use of Egb 761® 240 mg/day for 3 months had a statistically significant positive impact on cognitive functions (improvements in short-term memory, concentration, and thinking speed and everyday activity.Conclusion. The authors consider that CIs are the first sign of encephalopathy in DM2. It is also noted that DM2 has a more pronounced impact on cognitive functions than hypertension. Egb 761® can be used as an effective drug to treat CI in these diseases.

  5. Aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril as initial choice in hypertensive type II diabetic individuals: effects on albumin excretion, endothelial function and inflammation in a double-blind, randomized clinical trial

    NARCIS (Netherlands)

    van Meeteren-Schram, M.T.; van Ittersum, F.J.; Man, A.M.E.; van Dijk, R.A.; Schalkwijk, C.G.; IJzerman, R.G.; Twisk, J.W.R.; Stehouwer, C.D.A.

    2005-01-01

    We investigated the effects of aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril on urinary albumin excretion, endothelial function and inflammatory activity in hypertensive type II diabetic individuals. A total of 70 hypertensive type II diabetic

  6. Tissue Doppler echocardiography in persons with hypertension, diabetes, or ischaemic heart disease: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Mogelvang, Rasmus; Sogaard, Peter; Pedersen, Sune A

    2009-01-01

    AIMS: To test the hypothesis that echocardiographic tissue Doppler imaging (TDI) reveals reduced myocardial function in hypertension, diabetes, and ischaemic heart disease (IHD) in the general population. METHODS AND RESULTS: Within a large, community-based population study, cardiac function...... and diastolic cardiac function in hypertension [n = 345; LD 10.1 (+/-standard deviation, SD 2.0 mm), P diabetes [n = 65; LD 9.8 (+/-SD 2.2 mm), P ....001] compared with controls [n = 533; LD 11.4 (+/-SD 2.0 mm); E/e' 9.0 (x/SD 1.3)]. This pattern remained significant after adjusting for age, sex, body mass index, heart rate, and the results of conventional echocardiography. CONCLUSION: In the general population, persons with hypertension, diabetes, or IHD...

  7. A community-based screening campaign for the detection of diabetes mellitus and hypertension in the eastern province, Saudi Arabia: Methods and participation rates

    Directory of Open Access Journals (Sweden)

    Ageel J Al-Ghamdi

    2007-01-01

    Conclusion: Community screening campaigns for diabetes mellitus and hypertension is extremely efficient in identifying undiagnosed diabetic and hypertensive individuals. The most successful strategy for the screening and confirmation of results was through PHCCs, especially in the rural areas, where there was good organization and strict adherence to guidelines on methodology.

  8. Treatment Compliance among Patients with Hypertension and Type 2 Diabetes Mellitus in a Coastal Population of Southern India.

    Science.gov (United States)

    Rao, Chythra R; Kamath, Veena G; Shetty, Avinash; Kamath, Asha

    2014-08-01

    Hypertension and diabetes are major risk factors for cardiovascular and cerebrovascular disease. Adherence is a primary determinant of the effectiveness of treatment because poor adherence attenuates optimum clinical benefit and paves the way for complications. The cross-sectional community-based survey was carried out among men and women aged 30 years and above in the field practice area of a medical college to assess treatment compliance with respect to hypertension and type 2 diabetes mellitus. The study comprised of 426 subjects, already diagnosed with hypertension (287) and type 2 diabetes mellitus (139). During house visits, data were collected by personal face-to-face interview using a pre-tested structured questionnaire. Compliance was determined by indirect methods, which included self-reporting and interviews with the patients. Compliance to hypertension treatment was found to be 82.2%, while 83.6% of individuals with type 2 diabetes mellitus were on regular medication. Among the individuals on regular medication, 88 (37.3%) of them had controlled blood pressure. Although the compliance was good, blood pressure control was not optimal. Adherence was better among females as compared with males. Literacy status and socio-economic background were not found to be associated with treatment compliance. High cost of treatment for hypertension (39.3%) and diabetes (30.4%) and asymptomatic nature of the disease were the most common reasons cited for not taking regular medications. Adherence to hypertension and diabetes treatment was good. High cost of medications and asymptomatic nature of the disease were the reasons identified among the non-adherent patients.

  9. Treatment Compliance among Patients with Hypertension and Type 2 Diabetes Mellitus in a Coastal Population of Southern India

    Directory of Open Access Journals (Sweden)

    Chythra R Rao

    2014-01-01

    Full Text Available Background: Hypertension and diabetes are major risk factors for cardiovascular and cerebrovascular disease. Adherence is a primary determinant of the effectiveness of treatment because poor adherence attenuates optimum clinical benefit and paves the way for complications. Methods: The cross-sectional community-based survey was carried out among men and women aged 30 years and above in the field practice area of a medical college to assess treatment compliance with respect to hypertension and type 2 diabetes mellitus. The study comprised of 426 subjects, already diagnosed with hypertension (287 and type 2 diabetes mellitus (139. During house visits, data were collected by personal face-to-face interview using a pre-tested structured questionnaire. Compliance was determined by indirect methods, which included self-reporting and interviews with the patients. Results: Compliance to hypertension treatment was found to be 82.2%, while 83.6% of individuals with type 2 diabetes mellitus were on regular medication. Among the individuals on regular medication, 88 (37.3% of them had controlled blood pressure. Although the compliance was good, blood pressure control was not optimal. Adherence was better among females as compared with males. Literacy status and socio-economic background were not found to be associated with treatment compliance. High cost of treatment for hypertension (39.3% and diabetes (30.4% and asymptomatic nature of the disease were the most common reasons cited for not taking regular medications. Conclusions: Adherence to hypertension and diabetes treatment was good. High cost of medications and asymptomatic nature of the disease were the reasons identified among the non-adherent patients.

  10. [Effect of pre-existing hypertension on the prevalence and incidence of microalbuminuria in non insulin-dependent diabetic patients].

    Science.gov (United States)

    Suraniti, S; Daligaud, L; Chameau, A M; Marre, M; Fressinaud, P

    1991-08-01

    Microalbuminuria predicts increased rate of hypertension and mortality in insulino-dependent diabetics. In non insulin-dependent diabetes, hypertension often exists before onset of diabetes. To study effects of preexisting hypertension on prevalence and occurrence of elevated urinary albumin excretion (UAE), we collected datas from 614 non insulin-dependent diabetics, in a cross sectional survey: age was 60 +/- 10.4 years, (range 40-75 years), body mass index (BMI) 29 +/- 5.8 kg/m2, hemoglobin A1C 8 +/- 1.9%, systolic blood pressure (SBP) 134 +/- 18 mmHg, diastolic blood pressure (DBP) 76 +/- 10 mmHg, and serum creatinine 91 +/- 44 mumol/l. In the whole group, prevalence of hypertension was 59%. Microalbuminuria (EUA 20-200 mg/l) was present in 25.9% of the cases, microalbuminuria (EUA greater than 200 mg/l) in 7.5%. Cases with hypertension existing before or at onset of diabetes were 243 (HT group), cases without hypertension at onset were 371 (non HT group). In HT group, prevalence of microalbuminuria in increasing class of duration of diabetes were: 31% (0-4 years), 25% (5-9 years), 35% (10-14 years), 21% (15-19 years). Prevalence of macroalbuminuria was respectively: 3%, 11%, 15% and 4%. In the non HT group, microalbuminuria was present in 14% of the cases (0-4 years), 24% (5-9 years), 30% (10-14 years), 25% (15-19 years); prevalences of macroalbuminuria were: 1%, 8%, 6%, 15%. Mean values of UAE, compared to values of the class 0-2 years, were significantly higher in class 12-14 years (32.3 +/- 8 vs 14.4 +/- 3.7 mg/l; p = 0.02] in the HT group.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Association of acculturation and country of origin with self-reported hypertension and diabetes in a heterogeneous Hispanic population.

    Science.gov (United States)

    Rodriguez, Fátima; Hicks, LeRoi S; López, Lenny

    2012-09-11

    Hispanics are the fasting growing population in the U.S. and disproportionately suffer from chronic diseases such as hypertension and diabetes. Little is known about the complex interplay between acculturation and chronic disease prevalence in the growing and increasingly diverse Hispanic population. We explored the association between diabetes and hypertension prevalence among distinct U.S. Hispanic subgroups by country of origin and by degree of acculturation. We examined the adult participants in the 2001, 2003, 2005, and 2007 California Health Interview Survey (CHIS). Using weighted logistic regression stratified by nativity, we measured the association between country of origin and self-reported hypertension and diabetes adjusting for participants' demographics, insurance status, socio-economic status and degree of acculturation measured by citizenship, English language proficiency and the number of years of residence in the U.S. There were 33,633 self-identified Hispanics (foreign-born: 19,988; U.S.-born: 13,645). After multivariable adjustment, we found significant heterogeneity in self-reported hypertension and diabetes prevalence among Hispanic subgroups. Increasing years of U.S. residence was associated with increased disease prevalence. Among all foreign-born subgroups, only Mexicans reported lower odds of hypertension after adjustment for socioeconomic and acculturation factors. Both U.S.-born and foreign-born Mexicans had higher rates of diabetes as compared to non-Hispanic whites. We found significant heterogeneity among Hispanics in self-reported rates of hypertension and diabetes by acculturation and country of origin. Our findings highlight the importance of disaggregation of Hispanics by country of origin and acculturation factors whenever possible.

  12. Association of acculturation and country of origin with self-reported hypertension and diabetes in a heterogeneous Hispanic population

    Directory of Open Access Journals (Sweden)

    Rodriguez Fátima

    2012-09-01

    Full Text Available Abstract Background Hispanics are the fasting growing population in the U.S. and disproportionately suffer from chronic diseases such as hypertension and diabetes. Little is known about the complex interplay between acculturation and chronic disease prevalence in the growing and increasingly diverse Hispanic population. We explored the association between diabetes and hypertension prevalence among distinct U.S. Hispanic subgroups by country of origin and by degree of acculturation. Methods We examined the adult participants in the 2001, 2003, 2005, and 2007 California Health Interview Survey (CHIS. Using weighted logistic regression stratified by nativity, we measured the association between country of origin and self-reported hypertension and diabetes adjusting for participants’ demographics, insurance status, socio-economic status and degree of acculturation measured by citizenship, English language proficiency and the number of years of residence in the U.S. Results There were 33,633 self-identified Hispanics (foreign-born: 19,988; U.S.-born: 13,645. After multivariable adjustment, we found significant heterogeneity in self-reported hypertension and diabetes prevalence among Hispanic subgroups. Increasing years of U.S. residence was associated with increased disease prevalence. Among all foreign-born subgroups, only Mexicans reported lower odds of hypertension after adjustment for socioeconomic and acculturation factors. Both U.S.-born and foreign-born Mexicans had higher rates of diabetes as compared to non-Hispanic whites. Conclusions We found significant heterogeneity among Hispanics in self-reported rates of hypertension and diabetes by acculturation and country of origin. Our findings highlight the importance of disaggregation of Hispanics by country of origin and acculturation factors whenever possible.

  13. Predictive models to assess risk of type 2 diabetes, hypertension and comorbidity: machine-learning algorithms and validation using national health data from Kuwait--a cohort study.

    Science.gov (United States)

    Farran, Bassam; Channanath, Arshad Mohamed; Behbehani, Kazem; Thanaraj, Thangavel Alphonse

    2013-05-14

    We build classification models and risk assessment tools for diabetes, hypertension and comorbidity using machine-learning algorithms on data from Kuwait. We model the increased proneness in diabetic patients to develop hypertension and vice versa. We ascertain the importance of ethnicity (and natives vs expatriate migrants) and of using regional data in risk assessment. Retrospective cohort study. Four machine-learning techniques were used: logistic regression, k-nearest neighbours (k-NN), multifactor dimensionality reduction and support vector machines. The study uses fivefold cross validation to obtain generalisation accuracies and errors. Kuwait Health Network (KHN) that integrates data from primary health centres and hospitals in Kuwait. 270 172 hospital visitors (of which, 89 858 are diabetic, 58 745 hypertensive and 30 522 comorbid) comprising Kuwaiti natives, Asian and Arab expatriates. Incident type 2 diabetes, hypertension and comorbidity. Classification accuracies of >85% (for diabetes) and >90% (for hypertension) are achieved using only simple non-laboratory-based parameters. Risk assessment tools based on k-NN classification models are able to assign 'high' risk to 75% of diabetic patients and to 94% of hypertensive patients. Only 5% of diabetic patients are seen assigned 'low' risk. Asian-specific models and assessments perform even better. Pathological conditions of diabetes in the general population or in hypertensive population and those of hypertension are modelled. Two-stage aggregate classification models and risk assessment tools, built combining both the component models on diabetes (or on hypertension), perform better than individual models. Data on diabetes, hypertension and comorbidity from the cosmopolitan State of Kuwait are available for the first time. This enabled us to apply four different case-control models to assess risks. These tools aid in the preliminary non-intrusive assessment of the population. Ethnicity is seen significant

  14. Association Between Sleep-Disordered Breathing and Hypertensive Disorders of Pregnancy and Gestational Diabetes Mellitus.

    Science.gov (United States)

    Facco, Francesca L; Parker, Corette B; Reddy, Uma M; Silver, Robert M; Koch, Matthew A; Louis, Judette M; Basner, Robert C; Chung, Judith H; Nhan-Chang, Chia-Ling; Pien, Grace W; Redline, Susan; Grobman, William A; Wing, Deborah A; Simhan, Hyagriv N; Haas, David M; Mercer, Brian M; Parry, Samuel; Mobley, Daniel; Hunter, Shannon; Saade, George R; Schubert, Frank P; Zee, Phyllis C

    2017-01-01

    To estimate whether sleep-disordered breathing during pregnancy is a risk factor for the development of hypertensive disorders of pregnancy and gestational diabetes mellitus (GDM). In this prospective cohort study, nulliparous women underwent in-home sleep-disordered breathing assessments in early (6-15 weeks of gestation) and midpregnancy (22-31 weeks of gestation). Participants and health care providers were blinded to the sleep test results. An apnea-hypopnea index of 5 or greater was used to define sleep-disordered breathing. Exposure-response relationships were examined, grouping participants into four apnea-hypopnea index groups: 0, greater than 0 to less than 5, 5 to less than 15, and 15 or greater. The study was powered to test the primary hypothesis that sleep-disordered breathing occurring in pregnancy is associated with an increased incidence of preeclampsia. Secondary outcomes were rates of hypertensive disorders of pregnancy, defined as preeclampsia and antepartum gestational hypertension, and GDM. Crude and adjusted odds ratios and 95% confidence intervals (CIs) were calculated from univariate and multivariate logistic regression models. Three thousand seven hundred five women were enrolled. Apnea-hypopnea index data were available for 3,132 (84.5%) and 2,474 (66.8%) women in early and midpregnancy, respectively. The corresponding prevalence of sleep-disordered breathing was 3.6% and 8.3%. The prevalence of preeclampsia was 6.0%, hypertensive disorders of pregnancy 13.1%, and GDM 4.1%. In early and midpregnancy the adjusted odds ratios for preeclampsia when sleep-disordered breathing was present were 1.94 (95% CI 1.07-3.51) and 1.95 (95% CI 1.18-3.23), respectively; hypertensive disorders of pregnancy 1.46 (95% CI 0.91-2.32) and 1.73 (95% CI 1.19-2.52); and GDM 3.47 (95% CI 1.95-6.19) and 2.79 (95% CI 1.63-4.77). Increasing exposure-response relationships were observed between apnea-hypopnea index and both hypertensive disorders and GDM. There is an

  15. Effect of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics.

    Science.gov (United States)

    Logan, Alexander G; Irvine, M Jane; McIsaac, Warren J; Tisler, Andras; Rossos, Peter G; Easty, Anthony; Feig, Denice S; Cafazzo, Joseph A

    2012-07-01

    Lowering blood pressure reduces cardiovascular risk, yet hypertension is poorly controlled in diabetic patients. In a pilot study we demonstrated that a home blood pressure telemonitoring system, which provided self-care messages on the smartphone of hypertensive diabetic patients immediately after each reading, improved blood pressure control. Messages were based on care paths defined by running averages of transmitted readings. The present study tests the system's effectiveness in a randomized, controlled trial in diabetic patients with uncontrolled systolic hypertension. Of 244 subjects screened for eligibility, 110 (45%) were randomly allocated to the intervention (n = 55) or control (n = 55) group, and 105 (95.5%) completed the 1-year outcome visit. In the intention-to-treat analysis, mean daytime ambulatory systolic blood pressure, the primary end point, decreased significantly only in the intervention group by 9.1 ± 15.6 mmHg (SD; P blood pressure telemonitoring combined with automated self-care support reduced the blood pressure of diabetic patients with uncontrolled systolic hypertension and improved hypertension control. Home blood pressure monitoring alone had no effect on blood pressure. Promoting patient self-care may have negative psychological effects.

  16. Pseudo Foster Kennedy Syndrome secondary to uncontrolled hypertension and diabetes mellitus: A case report

    Directory of Open Access Journals (Sweden)

    Kavita R Bhatnagar

    2014-01-01

    Full Text Available Pseudo-Foster Kennedy Syndrome is described as unilateral optic disc swelling with contra lateral optic atrophy in the absence of an intracranial mass causing compression of the optic nerve. This occurs typically due to bilateral sequential optic neuritis or ischemic optic neuropathy. We describe a case of pseudo-Foster Kennedy Syndrome in a 37-year-old male with unilateral papilledema secondary to malignant hypertension and pre-existing ischemic optic neuropathy in other eye preventing transmission of raised intracranial pressure to the optic nerve. Hypertension and diabetes mellitus (DM play a significant role in pathogenesis of ischemic optic neuropathy. There is a greater correlation in patients with small disc and little to no cupping. The disorder commonly occurs in the 40-65 yrs age group. Our case is an example of Pseudo-Foster Kennedy syndrome where papilledema in one eye was associated with uncontrolled hypertension and disc pallor in fellow eye was secondary to ischemic optic neuropathy.

  17. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury.

    Science.gov (United States)

    James, Matthew T; Grams, Morgan E; Woodward, Mark; Elley, C Raina; Green, Jamie A; Wheeler, David C; de Jong, Paul; Gansevoort, Ron T; Levey, Andrew S; Warnock, David G; Sarnak, Mark J

    2015-10-01

    Diabetes mellitus and hypertension are risk factors for acute kidney injury (AKI). Whether estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (ACR) remain risk factors for AKI in the presence and absence of these conditions is uncertain. Meta-analysis of cohort studies. 8 general-population (1,285,045 participants) and 5 chronic kidney disease (CKD; 79,519 participants) cohorts. Cohorts participating in the CKD Prognosis Consortium. Diabetes and hypertension status, eGFR by the 2009 CKD Epidemiology Collaboration creatinine equation, urine ACR, and interactions. Hospitalization with AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results. During a mean follow-up of 4 years, there were 16,480 episodes of AKI in the general-population and 2,087 episodes in the CKD cohorts. Low eGFRs and high ACRs were associated with higher risks of AKI in individuals with or without diabetes and with or without hypertension. When compared to a common reference of eGFR of 80mL/min/1.73m(2) in nondiabetic patients, HRs for AKI were generally higher in diabetic patients at any level of eGFR. The same was true for diabetic patients at all levels of ACR compared with nondiabetic patients. The risk gradient for AKI with lower eGFRs was greater in those without diabetes than with diabetes, but similar with higher ACRs in those without versus with diabetes. Those with hypertension had a higher risk of AKI at eGFRs>60mL/min/1.73m(2) than those without hypertension. However, risk gradients for AKI with both lower eGFRs and higher ACRs were greater for those without than with hypertension. AKI identified by diagnostic code. Lower eGFRs and higher ACRs are associated with higher risks of AKI among individuals with or without either diabetes or hypertension. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  18. The complex scenario of obesity, diabetes and hypertension in the area of influence of primary healthcare facilities in Mexico.

    Science.gov (United States)

    Alcalde-Rabanal, J E; Orozco-Núñez, E; Espinosa-Henao, O E; Arredondo-López, A; Alcayde-Barranco, L

    2018-01-01

    Among non-communicable chronic diseases (NCCD), diabetes and hypertension are the main cause of adult mortality worldwide. Among the members of the Organization for Economic Cooperation and Development, Mexico is first in prevalence of diabetes and second in obesity. To face this problematic situation of NCCDs the Ministry of Health declared a national epidemiological alert against the overweight, obesity and diabetes. The target of this study is to characterize the status of obesity, diabetes and hypertension in the adult population in the area of influence of primary health facilities located in high social marginality areas. We conducted a cross-sectional observational study and used a convenience sample. A survey was conducted on a population of 18 years old and above in four primary health facilities in four Mexican States. The survey explored sociodemographic characteristics, the presence of chronic diseases, the access to healthcare services, risk factors and life styles. We also applied a complementary questionnaire to 20% of the participants, in order to explore food consumption during the last week and physical activity (International Physical Activity Questionnaire). We based our analysis on descriptive statistics and logistic multivariate regression to analyze factors associated with diabetes and hypertension. 73% (n = 7531, CI 0.72-0.74) percent of the population reported being diabetic, hypertensive and/or overweight. The majority of them receive healthcare in public health services. People over 40 years old, are 11 times more probable of living with diabetes and 8.7 times more probable of living with hypertension. Both conditions affect mostly women, whose main activity is to be a housewife. People who have lunch and dinner out of home are more likely to develop diabetes. People who perform intense physical activity are less likely to live with hypertension. According to the self-report, more than 70% of adult population living in areas with high

  19. Mortality and Macrovascular Risk in Elderly with Hypertension and Diabetes: Effect of Intensive Drug Therapy.

    Science.gov (United States)

    Yashkin, Arseniy P; Kravchenko, Julia; Yashin, Anatoliy I; Sloan, Frank

    2017-08-14

    This study identifies the effect of intensive drug therapy in individuals age 65+ with diabetes (T2D) and hypertension on all-cause death, congestive heart failure (CHF) and hospitalization for myocardial infarction (MI) and stroke/transient ischemic attack (stroke/TIA). Individuals from the Medicare 5% dataset with hypertension and T2D undergoing intensive drug therapy for these conditions were propensity score matched to a non-intensive-drug-therapy group. Hazard ratios (HR) were obtained using the Cox proportional hazard model. Intensive drug therapy was associated with increased risk of CHF [HR: 2.32; 95% Confidence Interval (CI): 2.32-2.38], MI [HR: 4.27; CI: 4.05-4.52], and stroke/TIA [HR: 1.80; CI: 1.70-1.89] but decreased risk of death [HR: 0.95; CI: 0.93-0.97]. Risk for CHF [HR: 0.73; CI: 0.71-0.73], MI [HR: 0.64; CI: 0.62-0.67], stroke/TIA [HR: 0.82; CI: 0.78-0.86] and death [HR: 0.29; CI: 0.28-0.29] was decreased by adherence to diabetes management guidelines. Use of intensive drug therapy in a high-risk population delays death but not severe macrovascular outcomes. Protective effects of intensive drug therapy in high risk patients likely outweigh polypharmacy-related health concerns.

  20. Socioeconomic position and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya.

    Science.gov (United States)

    Ploubidis, George B; Mathenge, Wanjiku; De Stavola, Bianca; Grundy, Emily; Foster, Allen; Kuper, Hannah

    2013-02-01

    We examined the extent to which the association between socioeconomic position (SEP) and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya is mediated by health-related behaviour. We used data from a community survey of 4,314 participants sampled from urban and rural areas in Nakuru, Kenya. Structural equation modelling was employed to estimate the direct and indirect--via health-related behaviour--effects of SEP on the three health outcomes. The accumulation of material resources was positively associated with hypertension and diabetes, whereas both education and material resources had a negative association with the prevalence of visual impairment. However, the observed health inequalities were not due to variation between SEP groups in health-related behaviour. The pattern of associations between education, material resources and the three health outcomes varied, suggesting that in Kenya, unlike the observed pattern of inequalities in high income countries, different dimensions of SEP provide different aspects of protection as well as risk. Smoking and alcohol use did not appear to mediate the observed associations, in contrast with countries past the epidemiologic transition.

  1. [Hypertension and prehypertension in children and adolescents with diabetes type 1].

    Science.gov (United States)

    Machnica, Lukasz; Deja, Grazyna; Jarosz-Chobot, Przemysława

    2008-01-01

    The aim of the study was to evaluate the prevalence of hypertension, prehypertension and circadian blood pressure rhythm disturbances with the analysis of chosen cardio-vascular risk factors in children and adolescents with diabetes type 1 (T1DM). The study group comprised 100 type 1 diabetic children (51 girls) with the mean age 15.4+/-2.58 years and mean diabetes duration 7.02+/-2.93 years. All subjects had an ambulatory blood pressure measurement (ABPM) as well as HbA1c, blood lipids and microalbuminuria assessment performed. 30 (30%) patients during the day period and 26 (26%) during the night period had their mean systolic BP (SBP) elevated beyond the 95-th percentile (for sex, age and height) in more than 40% of measurements. Corresponding diastolic BP (DBP) elevation occurred during the day in 3 (3%) and during the night in 2 (2%) patients. Prehypertension was revealed in 39 (39%) patients. Lack of physiological BP decrease during the night (Non-dipper) appeared in 48 (48%) subjects. A negative correlation between HDL and mean 24-hour SBP (r=-0.412, p<0.05) as well as mean night SBP (r=-0.520, p<0.01) in the group with hypertension was found. There was also a positive correlation between triglycerides (TG) level and mean 24-hour DBP (r=0.443, p<0.05) as well as mean night SBP (r=0.467, p<0.05) in the same group. The hypertension group presented with significantly lower mean HbA1c than the subjects without elevated BP (8.42+/-2.09% vs. 7.16+/-1.06%, p<0.05). Subjects with blunted 24-hour blood pressure variation (Non-dippers) had significantly higher BMI (p<0.05) and TG concentrations (p<0.05) and significantly lower HDL (p<0.05). Both hypertension and prehypertension are common disorders in young patients with T1DM. Lack of physiological BP decrease during the night seems to be connected with higher BMI and triglycerides and with lower HDL cholesterol.

  2. Interaction between diabetes mellitus and hypertension on risk of hearing loss in highly endogamous population.

    Science.gov (United States)

    Bener, Abdulbari; Al-Hamaq, Abdulla O A A; Abdulhadi, Khalid; Salahaldin, Ahmed H; Gansan, Loida

    2017-11-01

    that adults with DM and hypertension associated showed greater hearing impairment in highly endogamous population… Diabetic patients with hearing loss were likely to have high blood glucose and other risk factors like hypertension, retinopathy, nephropathy and neuropathy. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  3. Obesity, hypertension and diabetes mellitus affect complication rate of different nephrectomy techniques.

    Science.gov (United States)

    Hua, X; Ying-Ying, C; Zu-Jun, F; Gang, X; Zu-Quan, X; Qiang, D; Hao-Wen, J

    2014-12-01

    To investigate whether obesity, hypertension, and diabetes mellitus (DM) would increase post-nephrectomy complication rates using standardized classification method. We retrospectively included 843 patients from March 2006 to November 2012, of whom 613 underwent radical nephrectomy (RN) and 229 had partial nephrectomy (PN). Modified Clavien classification system was applied to quantify complication severity of nephrectomy. Fisher's exact or chi-square test was used to assess the relationship between complication rates and obesity, hypertension, as well as DM. The prevalence of obesity, hypertension, and DM was 11.51%, 30.84%, 8.78%, respectively. The overall complication rate was 19.31%, 30.04%, 35.71% and 36.36% for laparoscopic radical nephrectomy (LRN), open-RN, LPN and open-PN respectively. An increasing trend of low grade complication rate as BMI increased was observed in LRN (P=.027) and open-RN (Pcomplications in LRN (OR=4.471; 95% CI: 1.290-17.422; P=0.031) and open-RN (OR=2.448; 95% CI: 1.703-3.518; Pcomplications, especially grade ii complications in open-RN (OR=1.526; 95% CI: 1.055-2.206; P=.026) and open PN (OR=2.032; 95% CI: 1.199-3.443; P=.009). DM was also associated with higher grade i complication rate in open-RN (OR=2.490; 95% CI: 331-4.657; P=.016) and open-PN (OR=4.425; 95% CI: 1.815-10.791; P=.013). High grade complication rates were similar in comparison. Obesity, hypertension, and DM were closely associated with increased post-nephrectomy complication rates, mainly low grade complications. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  4. Viden, virkning og virke

    DEFF Research Database (Denmark)

    traditioner og vante tænkemåder. Relationerne mellem politiske og administrative beslutningstagere, sundhedsprofessionelle og patienter/borgere og deres foreninger forandres, og viden, politik og sundhed mødes og brydes på nye måder.   Har vi bevæget os fra en velfærdsstat til en konkurrencestat? Hvad betyder...

  5. Oral physiology, nutrition and quality of life in diabetic patients associated or not with hypertension and beta-blockers therapy.

    Science.gov (United States)

    Pereira, L J; Foureaux, R C; Pereira, C V; Alves, M C; Campos, C H; Rodrigues Garcia, R C M; Andrade, E F; Gonçalves, T M S V

    2016-07-01

    The relationship between type 2 diabetes oral physiology, nutritional intake and quality of life has not been fully elucidated. We assessed the impact of type 2 diabetes - exclusive or associated with hypertension with beta-blockers treatment - on oral physiology, mastication, nutrition and quality of life. This cross-sectional study was performed with 78 complete dentate subjects (15 natural teeth and six masticatory units minimum; without removable or fixed prostheses), divided into three groups: diabetics (DM) (n = 20; 45·4 ± 9·5 years), diabetics with hypertension and receiving beta-blockers treatment (DMH) (n = 19; 41·1 ± 5·1 years) and controls (n = 39; 44·5 ± 11·7 years) matched for gender, age and socioeconomic status. Blood glucose, masticatory performance, swallowing threshold, taste, food intake, stimulated and unstimulated salivary flow, pH and buffering capacity of saliva were assessed. Glycemia was higher in DM than in controls (P quality of life. Both stimulated and unstimulated salivary flow rate were lower in DMH (P diabetes did not alter oral physiology, nutrition or quality of life. However, when hypertension and beta-blockers treatment were associated with diabetes, the salivary flow rate, chewing cycles and number of teeth decreased. © 2016 John Wiley & Sons Ltd.

  6. KCNQ1 variants associate with hypertension in type 2 diabetes and affect smooth muscle contractility in vitro.

    Science.gov (United States)

    Huang, Kuo-Chin; Li, Te-Mao; Liu, Xiang; Chen, Jin-Hua; Chien, Wen-Kuei; Shiao, Yi-Tzone; Tsang, Hsinyi; Lin, Ting-Hsu; Liao, Chiu-Chu; Huang, Shao-Mei; Li, Ju-Pi; Lin, Cheng-Wen; Lin, Jung-Chun; Lin, Chih-Chien; Lai, Chih-Ho; Cheng, Chi-Fung; Liang, Wen-Miin; Hung, Chien-Hui; Chen, Ching-Chu; Lin, Ying-Ju; Tsai, Fuu-Jen

    2017-12-01

    KCNQ1 encodes a potassium voltage-gated channel and represents a susceptibility locus for type 2 diabetes mellitus (T2DM). Here, we explored the association between KCNQ1 polymorphisms and hypertension risk in individuals with T2DM, as well as the role of KCNQ1 in vascular smooth muscle cell contraction in vitro. To investigate the relationship between KCNQ1 and the risk of developing hypertension in patients with T2DM, we divided the T2DM cohort into hypertension (n = 452) and non-hypertension (n = 541) groups. The Mann-Whitney U test, chi-square test, and multivariate regression analyses were used to assess the clinical characteristics and genotypic frequencies. In vitro studies utilized the rat aortic smooth muscle A10 cell line. Patients in the hypertension group were significantly older at the time of enrollment and had higher levels of body mass index, waist-to-hip ratio, and triglyceride than those in the non-hypertension group. The KCNQ1 rs3864884 and rs12576239 genetic variants were associated with hypertension in T2DM. KCNQ1 expression was lower in the individuals with the CC versus the CT and TT genotypes. Smooth muscle cell contractility was inhibited by treatment with a KCNQ1 inhibitor. These results suggest that KCNQ1 might be associated with hypertension in individuals with T2DM. © 2017 Wiley Periodicals, Inc.

  7. Association of obesity with hypertension and dyslipidemia in type 2 diabetes mellitus subjects.

    Science.gov (United States)

    Anari, Razieh; Amani, Reza; Latifi, Seyed Mahmoud; Veissi, Masoud; Shahbazian, Hajieh

    Obesity and diabetes are contributed to cardiovascular disease risk. The current study was performed to evaluate the association of central and general obesity and cardio-metabolic risk factors, including dyslipidemia and hypertension in T2DM patients. This was a cross-sectional study in T2DM adults. Body mass index (BMI) was used to identify general obesity and waist circumference (WC) was measured to define abdominal obesity (based on ATP III). Biochemical analyses, and anthropometric and blood pressure measurements were done for all participants. Participants with central obesity showed significantly higher systolic (132.5mmHg vs. 125.4mmHg, p=0.024) and diastolic blood pressures (84.9mmHg vs. 80mmHg, p=0.007) than participants without obesity. Dyslipidemia was more prevalent in all participants either by BMI (98.3% vs. 97%, 95% CI: 0.18-17.53) or by WC (97.2% vs. 98%, 95% CI: 0.07-7.19). Abdominal adiposity in diabetic subjects showed significant reverse association with high level of physical activity (OR=0.22, 95% CI: 0.06-0.85). Hypertriglyceridemia rate was increased with both central (OR=2.11; p=0.040) and general obesity (OR=2.68; p=0.021). After adjustment for energy intake and age, females had higher risk of general (OR=4.57, 95% CI=1.88-11.11) and central obesity (OR=7.93, 95% CI=3.48-18.08). Females were more susceptible to obesity. Hypertension was associated with both obesity measures. Dyslipidemia, except for hypertriglyceridemia, was correlated to neither abdominal nor general obesity. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  8. High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension.

    Science.gov (United States)

    Rostami, Ali; Khalili, Mohammad; Haghighat, Neda; Eghtesadi, Shahryar; Shidfar, Farzad; Heidari, Iraj; Ebrahimpour-Koujan, Soraiya; Eghtesadi, Maryam

    2015-01-01

    The aim was to examine the effects of high-cocoa polyphenol-rich chocolate on lipid profiles, weight, blood pressure, glycemic control, and inflammation in individuals with Type 2 diabetes and hypertension. Sixty individuals [32 in dark chocolate group (DCG) and 28 in white chocolate group (WCG)] with Type 2 diabetes on stable medication were enrolled in a randomized, placebo-controlled double-blind study. Subjects were randomized to consume 25 g DCG or WCG for 8 weeks. Changes in weight, blood pressure, glycemic control, lipid profile, and high sensitive C-reactive protein (hsCRP) were measured at the beginning and end of the intervention. This clinical trial was registered at the Iranian registry of clinical trials. In DCC group, compared with baseline, serum levels of Apo A-1 (P = 0.045) was increased and fasting blood sugar (FBS) (P = 0.027), hemoglobin A1c (HbA1c) (P = 0.025), Apo B (P = 0.012) and Log of hsCRP (P = 0.043) levels were decreased at the end of study. No changes were seen within the WCG in studied parameters. High polyphenol chocolate consumption compared to white chocolate resulted in significant decrease in of systolic (-5.93 ± 6.25 vs. -1.07 ± 7.97 mmHg, P = 0.004) and diastolic blood pressure (-6.4 ± 6.25 vs. 0.17 ± 7.9 mmHg, P = 0.002), FBS (-7.84 ± 19.15 vs. 4.00 ± 20.58 mg/dl, P = 0.019) over the course of 8 weeks of daily chocolate consumption neither weight nor body mass index and TG levels altered from baseline. High polyphenol chocolate is effective in improving TG levels in hypertensive patients with diabetes and decreasing blood pressure and FBS without affecting weight, inflammatory markers, insulin resistance or glycemic control.

  9. Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: Systematic review and metaanalysis

    Directory of Open Access Journals (Sweden)

    King Michael B

    2008-09-01

    Full Text Available Abstract Background Severe mental illnesses (SMI may be independently associated with cardiovascular risk factors and the metabolic syndrome. We aimed to systematically assess studies that compared diabetes, dyslipidaemia, hypertension and metabolic syndrome in people with and without SMI. Methods We systematically searched MEDLINE, EMBASE, CINAHL & PsycINFO. We hand searched reference lists of key articles. We employed three search main themes: SMI, cardiovascular disease, and each cardiovascular risk factor. We selected cross-sectional, case control, cohort or intervention studies comparing one or more risk factor in both SMI and a reference group. We excluded studies without any reference group. We extracted data on: study design, cardiovascular risk factor(s and their measurement, diagnosis of SMI, study setting, sampling method, nature of comparison group and data on key risk factors. Results Of 14592 citations, 134 papers met criteria and 36 were finally included. 26 reported on diabetes, 12 hypertension, 11 dyslipidaemia, and 4 metabolic syndrome. Most studies were cross sectional, small and several lacked comparison data suitable for extraction. Meta-analysis was possible for diabetes, cholesterol and hypertension; revealing a pooled risk ratio of 1.70 (1.21 to 2.37 for diabetes and 1.11 (0.91 to 1.35 of hypertension. Restricting SMI to schizophreniform illnesses yielded a pooled risk ratio for diabetes of 1.87 (1.68 to 2.09. Total cholesterol was not higher in people with SMI (Standardized Mean Difference -0.10 (-0.55 to 0.36 and there were inconsistent data on HDL, LDL and triglycerides with some, but not all, reporting lower levels of HDL cholesterol and raised triglyceride levels. Metabolic syndrome appeared more common in SMI. Conclusion Diabetes (but not hypertension is more common in SMI. Data on other risk factors were limited by poor quality or inconsistent research findings, but a small number of studies show greater prevalence

  10. Using multistate observational studies to determine role of hypertension and diabetes as risk factors for dementia

    Directory of Open Access Journals (Sweden)

    Mitasha Singh

    2016-01-01

    Full Text Available Background: Evidence suggests that modifiable risk factors which can be targeted by prevention are vascular diseases, such as diabetes, midlife hypertension (HTN, midlife obesity, midlife cholesterol, mid- and late-life depression as well as lifestyle factors such as smoking, physical inactivity, and poor diet. Methods: A comprehensive search of the National Library of Medicine's PubMed database and Google Scholar was conducted. A combinations of medical subject headings and free text words that included search terms related to the exposure (e.g., prevalence, HTN, raised BP, high BP, diabetes, high blood sugar, DM, India, state, were combined with search terms related to the outcomes (e.g., prevalence, disease burden, estimate, dementia, India. The filters included were English for the language category and humans for the study category. Results: The PubMed search initially identified 269 references, and a total of 204 abstracts were screened by inclusion criteria. Full-text assessment of 136 articles on prevalence of dementia resulted in 20 relevant articles from which the different regions of the country were identified. Based on the search conducted according to the regions; 287abstracts of the prevalence of HTN and 577 on the prevalence of diabetes mellitus were screened. There were 43 full-text articles on the prevalence of HTN and diabetes from the regions where the prevalence of dementia was available. Of these potentially relevant articles were 14 in number. Conclusion: Despite the uncertainty in the role, the data analysis, therefore, points to a role in the prevention of HTN and diabetes to prevent dementia.

  11. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus: longitudinal study.

    Science.gov (United States)

    Qiu, Miaoyan; Shen, Weili; Song, Xiaomin; Ju, Liping; Tong, Wenxin; Wang, Haiyan; Zheng, Sheng; Jin, Yan; Wu, Yixin; Wang, Weiqing; Tian, Jingyan

    2015-03-01

    Whether prediabetes mellitus alone or combined with other disorders means a higher risk for cardiovascular disease (CVD) is still controversial. This study aimed to investigate the association between prediabetes mellitus and CVD and diabetes mellitus and to explore whether prediabetes mellitus alone or combined with other syndromes, such as hypertension, could promote CVD risks significantly. This longitudinal population-based study of 1609 residents from Shanghai in Southern China was conducted between 2002 and 2014. Participants with a history of CVD at baseline were excluded from analysis. Multivariate log-binomial regression models were used to adjust possible coexisting factors. Incidence of CVD during follow-up was 10.1%. After adjusting for age, sex, and other factors, the association between prediabetes mellitus and CVD was not observed. When hypertension was incorporated in stratifying factors, adjusted CVD risk was elevated significantly (odds ratio, 2.41; 95% confidence interval, 1.25-4.64) in prediabetes mellitus and hypertension combined group, and coexistence of diabetes mellitus and hypertension made CVD risk highly significantly increased, reaching 3.43-fold higher than the reference group. Blood glucose level within prediabetic range is significantly associated with elevated risks for diabetes mellitus after multivariable adjustment, but only when it is concurrent with other disorders, such as hypertension, it will significantly increase CVD risk. © 2015 American Heart Association, Inc.

  12. Professionel kompetence og uddannelse

    DEFF Research Database (Denmark)

    Hedegaard, Karen Marie

    Specialet behandler forholdet mellem professionel kompetence og uddannelse gennem en undersøgelse og diskussion af teorier og forskning om professionsbegrebet i sociologien historisk og aktuelt, bl.a. Talcott Parsons, MaxWeber og Thomas Mathiesen, og diskuterer forskellige forståelser af professi......Specialet behandler forholdet mellem professionel kompetence og uddannelse gennem en undersøgelse og diskussion af teorier og forskning om professionsbegrebet i sociologien historisk og aktuelt, bl.a. Talcott Parsons, MaxWeber og Thomas Mathiesen, og diskuterer forskellige forståelser af...

  13. Screening for Cognitive Dysfunction Helped to Unmask Silent Cerebrovascular Disease in a Hypertensive Diabetic Patient — Case Report

    Directory of Open Access Journals (Sweden)

    Germán-Salló Márta

    2017-06-01

    Full Text Available The current guidelines for the diagnosis and treatment of hypertension recommend screening for cognitive impairment in all hypertensive patients as part of the clinical assessment. However, the implementation of this recommendation in clinical practice is still unsatisfactory. We present the case of an elderly hypertensive female patient in order to highlight the importance of screening for cognitive impairment. A patient with a history of poorly controlled hypertension for the last 12 years and recently diagnosed with type 2 diabetes mellitus is admitted complaining of asthenia, dizziness, visual acuity impairment, and difficulty to remember recent information. Cardiovascular imaging showed 70% internal carotid artery stenosis in a neurologically asymptomatic patient. Cognitive testing showed mild cognitive impairment. Retinal imaging identified stage III hypertensive retinopathy accompanied by irreversible end-organ damage due to microvascular changes. At this point brain MRI was performed, which identified both macro- and microvascular brain lesions in the periventricular white matter and sequelae of a former ischemic stroke in the territory of the left posterior cerebral artery. Cognitive testing helped to unmask silent cerebrovascular disease in an otherwise oligosymptomatic hypertensive diabetic patient. Cognitive function testing should be introduced in routine clinical practice in order to help unmask silent cerebrovascular disease.

  14. Which body mass index is best associated with risk of diabetes mellitus and hypertension in a Japanese-Brazilian population?

    Directory of Open Access Journals (Sweden)

    Rosana Farah Simony

    Full Text Available The objective of this study was to evaluate the impact of different body mass index (BMI ranges associated with the risk of diabetes and hypertension in Japanese-Brazilians. This cross-sectional study was based on data from 1,330 Japanese-Brazilians > 30 years of age who participated in a population-based survey on the prevalence of diabetes mellitus and associated diseases. Glucose tolerance status was classified according to WHO criteria and blood pressure levels according to the VI-JNC. Odds ratios for diabetes and hypertension were calculated for different BMI ranges; for different BMIs, sensitivity and specificity for percentiles 25, 50, 75, 90 and 95 were obtained. Increased odds ratios for diabetes mellitus and hypertension were observed with BMI values > 25kg/m². The 50th percentile corresponded to the highest sensitivity and specificity for the identification of risk for both diseases. Our results suggest that BMI values proposed by WHO should also be useful for this group of Japanese descendants in the assessment of risk for DM and hypertension.

  15. Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

    Directory of Open Access Journals (Sweden)

    Machado Ubiratan F

    2011-04-01

    Full Text Available Abstract Background The effects of renal denervation on cardiovascular reflexes and markers of nephropathy in diabetic-hypertensive rats have not yet been explored. Methods Aim: To evaluate the effects of renal denervation on nephropathy development mechanisms (blood pressure, cardiovascular autonomic changes, renal GLUT2 in diabetic-hypertensive rats. Forty-one male spontaneously hypertensive rats (SHR ~250 g were injected with STZ or not; 30 days later, surgical renal denervation (RD or sham procedure was performed; 15 days later, glycemia and albuminuria (ELISA were evaluated. Catheters were implanted into the femoral artery to evaluate arterial pressure (AP and heart rate variability (spectral analysis one day later in conscious animals. Animals were killed, kidneys removed, and cortical renal GLUT2 quantified (Western blotting. Results Higher glycemia (p vs. nondiabetics (p vs. SHR. Conclusions Renal denervation in diabetic-hypertensive rats improved previously reduced heart rate variability. The GLUT2 equally overexpressed by diabetes and renal denervation may represent a maximal derangement effect of each condition.

  16. Amino-terminal pro-B-type natriuretic peptide testing in patients with diabetes mellitus and with systemic hypertension

    DEFF Research Database (Denmark)

    Hildebrandt, P.; Richards, A.M.

    2008-01-01

    with diabetes mellitus, hypertension, or known coronary artery disease) appears logical and is supported by data. NT-proBNP has strong prognostic value in such at-risk patients. However, the exact implications for clinical management after detection of an elevated NT-proBNP value should be driven by clinical...

  17. Plasma proteomics classifiers improve risk prediction for renal disease in patients with hypertension or type 2 diabetes

    NARCIS (Netherlands)

    Pena, Michelle J.; Jankowski, Joachim; Heinze, Georg; Kohl, Maria; Heinzel, Andreas; Bakker, Stephan J. L.; Gansevoort, Ron T.; Rossing, Peter; de Zeeuw, Dick; Heerspink, Hiddo J. Lambers; Jankowski, Vera

    2015-01-01

    OBJECTIVE: Micro and macroalbuminuria are strong risk factors for progression of nephropathy in patients with hypertension or type 2 diabetes. Early detection of progression to micro and macroalbuminuria may facilitate prevention and treatment of renal diseases. We aimed to develop plasma proteomics

  18. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice.

    NARCIS (Netherlands)

    Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

    2009-01-01

    BACKGROUND: Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without

  19. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury

    NARCIS (Netherlands)

    James, Matthew T.; Grams, Morgan E.; Woodward, Mark; Elley, C. Raina; Green, Jamie A.; Wheeler, David C.; de Jong, Paul; Gansevoort, Ron T.; Levey, Andrew S.; Warnock, David G.; Sarnak, Mark J.; de Zeeuw, Dick; Bakker, Stephan J. L.; van der Harst, Pim; Heerspink, Hiddo J.

    2015-01-01

    Background: Diabetes mellitus and hypertension are risk factors for acute kidney injury (AKI). Whether estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (ACR) remain risk factors for AKI in the presence and absence of these conditions is uncertain. Study Design:

  20. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice

    NARCIS (Netherlands)

    Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

    2009-01-01

    BACKGROUND: Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without

  1. Adiposity, hypertension and weight management behaviours in Ghanaian type 2 diabetes mellitus patients aged 20-70 years.

    Science.gov (United States)

    Mogre, Victor; Apala, Peter; Nsoh, Jonas A; Wanaba, Peter

    2016-01-01

    This study assessed the prevalence of general and abdominal obesity and hypertension as well the weight management behaviours of type 2 diabetes mellitus patients. It included 378 diabetes patients seeking care from two hospitals in Ghana. Standard methods and tools were used to assess participants' weight, height, waist circumference (WC), blood pressure (BP) and fasting plasma glucose (FPG). Weight management behaviours were measured using a questionnaire. The prevalence of general obesity, abdominal obesity and hypertension was 20.1%, 46.6% and 67.7% respectively. Abdominal obesity was more likely in participants who: skipped breakfast, engaged in exercise to lose weight and were generally overweight/obese. General overweight and obesity was more likely in participants who: reported receipt of weight management counselling, engaged in exercise to lose weight, had a weight management plan/goal, and were abdominally obese. Hypertension was less likely in participants who had: no formal education, diabetes for ≥5 years and modified their dietary habits to lose weight but more likely in those who skipped breakfast. Abdominal obesity, general overweight/obesity, and hypertension were frequent in this sample and were influenced by weight management behaviours. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  2. Results of a hypertension and diabetes treatment program in the slums of Nairobi: a retrospective cohort study

    NARCIS (Netherlands)

    Werner, Marie E.; van de Vijver, Steven; Adhiambo, Mildred; Egondi, Thaddaeus; Oti, Samuel O.; Kyobutungi, Catherine

    2015-01-01

    Cardiovascular diseases (CVD) are the world's leading cause of death and their prevalence is rising. Diabetes and hypertension, major risk factors for CVD, are highly prevalent among the urban poor in Africa, but treatment options are often limited in such settings. This study reports on the results

  3. Serum uric acid is associated with new-onset diabetes in hypertensive patients with left ventricular hypertrophy: The LIFE Study

    DEFF Research Database (Denmark)

    Wiik, Benedicte P; Larstorp, Anne C K; Høieggen, Aud

    2010-01-01

    It is unclear whether serum uric acid (SUA) is associated with development of new-onset diabetes (NOD) in patients with hypertension and left ventricular hypertrophy (LVH). The aim of the present investigation was to test the hypothesis that SUA predicts development of NOD in these patients....

  4. [Knowledge of the general population about hypertension and diabetes mellitus in South Kivu, Democratic Republic of Congo].

    Science.gov (United States)

    Katchunga, P B; Malanda, B; Mweze, M C; Dupont, B; M'Buyamba-Kabangu, J R; Kashongwe, Z; Kabinda, J M; Buysschaert, M

    2012-04-01

    In the Democratic Republic of Congo (DRC), a country in a post-conflict period, high priority cannot be given to non-communicable diseases other than to emergencies. This certainly involves inadequacy in raising awareness for prevention of these diseases. To evaluate the level of knowledge of the Congolese general population on hypertension and diabetes mellitus. Responses to a questionnaire from 3% of the general population aged 15 and older in the city of Bukavu and two rural areas: Hombo and Walungu (South Kivu, eastern DRC), recruited after stratification by ward in the city of Bukavu and a group of prone villages were expected. The questions focused on identification, testing, causes, complications and treatment of hypertension and diabetes mellitus. Of the 7770 respondents, screening for hypertension and diabetes mellitus affected only 14.9% and 7.3% of subjects respectively. Knowledge of these two conditions was generally low in the general population, although better in the subgroups of patients and those with higher socioeconomic level (Pknowledge (Pknowledge about hypertension and diabetes mellitus and their testing in South Kivu is low. It is imperative that the Congolese government includes non-communicable diseases in its priorities of the millennium. Similarly, the WHO should actively contribute to screening for them in low-income countries. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  5. Trends in hyperlipidemia and hypertension management in type 2 diabetes patients from 1998-2004 : a longitudinal observational study

    NARCIS (Netherlands)

    Greving, Jacoba P.; Denig, Petra; de Zeeuw, Dick; Bilo, Henk J. G.; Haaijer-Ruskamp, Flora M.

    2007-01-01

    Background: Lack of treatment initiation or intensification might explain why some patients with type 2 diabetes do not reach target goals. The objective is to assess trends in risk factor treatment, and identify determinants for medication adjustments in patients with uncontrolled hypertension

  6. Impact of computer-based pregnancy-induced hypertension and diabetes decision AIDS on empowering pregnant women

    NARCIS (Netherlands)

    Aslani, Azam; Tara, Fatemeh; Ghalighi, Lila; Pournik, Omid; Ensing, Sabine; Abu-Hanna, Ameen; Eslami, Saeid

    2014-01-01

    We designed a computer-based decision aid (CDA) for use by pregnant women at home to investigate and participate in solving their pregnancy problems related to pregnancy-induced hypertension (PIH) and gestational diabetes (GD). The system cannot and is not intended to replace visits to physicians;

  7. Placebo-controlled comparison of captopril, metoprolol, and hydrochlorothiazide therapy in non-insulin-dependent diabetic patients with primary hypertension

    DEFF Research Database (Denmark)

    Gall, M A; Rossing, P; Skøtt, P

    1992-01-01

    The antihypertensive effect of captopril, metoprolol, and hydrochlorothiazide was compared in 23 non-insulin-dependent (NIDDM) diabetic patients less than or equal to 75 years of age, with borderline to moderate primary hypertension. In a double blind, placebo-controlled cross-over trial the pati...

  8. Influence of arterial hypertension, type 2 diabetes and cardiovascular risk factors on ALS outcome: a population-based study.

    Science.gov (United States)

    Moglia, Cristina; Calvo, Andrea; Canosa, Antonio; Bertuzzo, Davide; Cugnasco, Paolo; Solero, Luca; Grassano, Maurizio; Bersano, Enrica; Cammarosano, Stefania; Manera, Umberto; Pisano, Fabrizio; Mazzini, Letizia; Dalla Vecchia, Laura A; Mora, Gabriele; Chiò, Adriano

    2017-11-01

    To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. A total of 650 ALS patients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2). At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients. This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.

  9. Diabetes, hypertension, and chronic kidney disease progression: role of DPP4.

    Science.gov (United States)

    Nistala, Ravi; Savin, Virginia

    2017-04-01

    The protein dipeptidyl peptidase 4 (DPP4) is a target in diabetes management and reduction of associated cardiovascular risk. Inhibition of the enzymatic function and genetic deletion of DPP4 is associated with tremendous benefits to the heart, vasculature, adipose tissue, and the kidney in rodent models of obesity, diabetes and hypertension, and associated complications. The recently concluded, "Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53" trial revealed a reduction in proteinuria in chronic kidney disease patients (stages 1-3). These results have spurred immense interest in the nonenzymatic and enzymatic role of DPP4 in the kidney. DPP4 is expressed predominantly in the glomeruli and S1-S3 segments of the nephron and to a lesser extent in other segments. DPP4 is known to facilitate absorption of cleaved dipeptides and regulate the function of the sodium/hydrogen exchanger-3 in the proximal tubules. DPP4, also known as CD26, has an important role in costimulation of lymphocytes via caveolin-1 on antigen-presenting cells in peripheral blood. Herein, we present our perspectives for the ongoing interest in the role of DPP4 in the kidney.

  10. Influence of gestational diabetes mellitus on the stereoselective kinetic disposition and metabolism of labetalol in hypertensive patients.

    Science.gov (United States)

    Carvalho, Teresa Maria J P; Cavalli, Ricardo de Carvalho; Cunha, Sérgio P; de Baraldi, Cláudia O; Marques, Maria P; Antunes, Natalícia J; Godoy, Ana Leonor P C; Lanchote, Vera Lucia

    2011-01-01

    This study investigated the influence of gestational diabetes mellitus on the kinetic disposition and stereoselective metabolism of labetalol administered intravenously or orally. Thirty hypertensive women during the last trimester of pregnancy were divided into four groups: non-diabetic and diabetic women treated with intravenous or oral labetalol. The pharmacokinetics of labetalol was not stereoselective in diabetic or non-diabetic pregnant women receiving the drug intravenously. However, oral administration of labetalol resulted in lower values of the area under the plasma concentration versus time curve (AUC) for the β-blocker (RR) than for the other enantiomers in both diabetic and non-diabetic women. Gestational diabetes mellitus caused changes in the kinetic disposition of the labetalol stereoisomers when administered orally. The AUC values for the less potent adrenoceptor antagonist (SS) and for the α-blocking (SR) isomers were higher in diabetic than in non-diabetic pregnant women. The approximately 100% higher AUC values obtained for the (SR) isomer in diabetic pregnant women treated with oral labetalol may be of clinical relevance in terms of the α-blocking activity of this isomer.

  11. Hypertension and diabetes as risk factors for dementia: A secondary post-hoc analysis from north-west India.

    Science.gov (United States)

    Raina, Sunil Kumar; Chander, Vishav; Raina, Sujeet; Kumar, Dinesh; Grover, Ashoo; Bhardwaj, Ashok

    2015-01-01

    A relation between midlife risk factors (hypertension and diabetes) and dementia has been studied in past and an association has been documented, in spite of some studies pointing to the contrary. The study was based on post-hoc analysis of data obtained from a study conducted on an elderly population (60 years and above) from selected geographical areas (migrant, urban, rural and tribal) of the Himachal Pradesh state in North-West India. Analysis of variance revealed an effect of risk factors on cognitive scores; however, post hoc Tukey's honest significant difference (HSD) test revealed that only hypertensives' demonstrated higher chances of scoring lower on cognitive measures. The possibility that hypertension and diabetes affect dementia needs further evaluation, more so in Indian context.

  12. Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population.

    Science.gov (United States)

    Axmon, Anna; Ahlström, Gerd; Höglund, Peter

    2017-11-23

    Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID) have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups. This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936). We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006-2012. The two cohorts were compared using generalized linear models (GLM). People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP) 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists. Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general population. To ensure that this is medically appropriate and not due to

  13. Health inequalities in hypertension and diabetes management among the poor in urban areas: a population survey analysis in south Korea.

    Science.gov (United States)

    Jeon, Young-Jee; Kim, Chung Reen; Park, Joo-Sung; Choi, Kyung-Hyun; Kang, Myoung Joo; Park, Seung Guk; Park, Young-Jin

    2016-06-10

    This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. In addition, the rate of good hypertension or diabetes control was examined separately in men and women, and in urban and rural areas. This study used Korea National Health and Nutrition Examination V (2010-2012) data, a nationwide cross-sectional survey of general South Korean population. Residential areas were categorized into urban and rural areas. To examine differences between the residential areas in terms of prevalence, awareness, treatment, and control of hypertension and diabetes we performed a multivariate logistic regression adjusting for age, body mass index, physical activity, alcohol use, smoking, marital status, monthly income, and educational level. To investigate control of hypertension or diabetes within each residential area, we performed a subgroup analysis in both urban and rural areas. The prevalence of hypertension is higher among men in urban areas than among those in rural areas (OR = 0.80; 95 % CI = 0.67-0.96, reference group = urban areas). However, the subgroups did not differ in terms of diabetes prevalence, awareness, treatment, and control. Regardless of both sex and residential area, participants in good control of their hypertension and diabetes were younger. Inequality in good control of hypertension was observed in men who lived in urban (≤Elementary school, OR 0.74, 95 % CI 0.60-0.92) and rural areas (≤Elementary school, OR 0.67, 95 % CI 0.46-0.99). Inequality in health status was found in women who resided in urban areas (≤Elementary school, OR 0.53, 95 % CI 0.37-0.75). Good control of diabetes also showed inequalities in health status for both men (≤Elementary school, OR 0.61, 95 % CI 0.40-0.94; Middle/High school, OR 0.69, 95 % CI 0.49-0.96) and women in urban areas (≤1 million won, OR 0.56, 95 % CI 0.33-0.93) (Reference group = '≥College' for education

  14. Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population

    Directory of Open Access Journals (Sweden)

    Anna Axmon

    2017-11-01

    Full Text Available Abstract Background Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups. Methods This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936. We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006–2012. The two cohorts were compared using generalized linear models (GLM. Results People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists. Conclusions Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general

  15. Health inequalities in hypertension and diabetes management among the poor in urban areas: a population survey analysis in south Korea

    Directory of Open Access Journals (Sweden)

    Young-Jee Jeon

    2016-06-01

    Full Text Available Abstract Background This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. In addition, the rate of good hypertension or diabetes control was examined separately in men and women, and in urban and rural areas. Methods This study used Korea National Health and Nutrition Examination V (2010–2012 data, a nationwide cross-sectional survey of general South Korean population. Residential areas were categorized into urban and rural areas. To examine differences between the residential areas in terms of prevalence, awareness, treatment, and control of hypertension and diabetes we performed a multivariate logistic regression adjusting for age, body mass index, physical activity, alcohol use, smoking, marital status, monthly income, and educational level. To investigate control of hypertension or diabetes within each residential area, we performed a subgroup analysis in both urban and rural areas. Results The prevalence of hypertension is higher among men in urban areas than among those in rural areas (OR = 0.80; 95 % CI = 0.67–0.96, reference group = urban areas. However, the subgroups did not differ in terms of diabetes prevalence, awareness, treatment, and control. Regardless of both sex and residential area, participants in good control of their hypertension and diabetes were younger. Inequality in good control of hypertension was observed in men who lived in urban (≤Elementary school, OR 0.74, 95 % CI 0.60–0.92 and rural areas (≤Elementary school, OR 0.67, 95 % CI 0.46–0.99. Inequality in health status was found in women who resided in urban areas (≤Elementary school, OR 0.53, 95 % CI 0.37–0.75. Good control of diabetes also showed inequalities in health status for both men (≤Elementary school, OR 0.61, 95 % CI 0.40–0.94; Middle/High school, OR 0.69, 95 % CI 0.49–0.96 and women in urban areas (≤1 million won, OR 0.56, 95

  16. Evaluation of antihypertensive therapy in diabetic hypertensive patients: impact of ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Shraim NY

    2009-03-01

    Full Text Available Macrovascular complications are common in diabetic hypertensive patients. Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication. Objective: To evaluate utilization patterns of antihypertensive agents and blood pressure (BP control among diabetic hypertensive patients with and without ischemic heart disease (IHD. Methods: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007. Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without IHD. Blood pressure control (equal or lower 130/80 mmHg was compared for patients receiving no therapy, monotherapy, or combination therapy and separately among patients with and without IHD. Results: 255 patients were included in the study; their mean age was 64.4 (SD=11.4 years. Sixty one (23.9% of the included patients was on target BP. Over 60% of the total patients were receiving angiotensin-converting enzyme inhibitors (ACEI/ angiotensin receptor blocker (ARB, followed by diuretics (40.8%, calcium channel blockers (25.1% and beta-blockers (12.5%. The majority (> 55% of patients were either on mono or no drug therapy. More than 55% of patients with controlled BP were using ACE-I. More than half (50.8% of the patients with controlled BP were on combination therapy while 42.3% of patients with uncontrolled BP were on combination therapy (p=0.24. More patient in the IHD achieved target BP than those in non-IHD group (p=0.019. Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups. Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines. Areas of improvement include

  17. Determining the amounts of urea and glucose in urine of patients with renal complications from diabetes mellitus and hypertension by near-infrared Raman spectroscopy

    Science.gov (United States)

    Bispo, Jeyse A. M.; Silveira, Landulfo; Vieira, Elzo E. d. S.; Fernandes, Adriana B.

    2013-02-01

    Diabetes mellitus and hypertension diseases are frequently found in the same patient, which if untreated predispose to atherosclerotic and kidney diseases. The objective of this study was to identify potential biomarkers in the urine of diabetic and hypertensive patients through dispersive near-infrared Raman spectroscopy. Urine samples were collected from patients with diabetes and hypertension but no complications (LG), high degree of complications (HG), and control ones: one fraction was submitted to biochemical tests and another one was stored frozen (-20°C) until spectral analysis. Samples were warmed up and placed in an aluminum sample holder for Raman spectra collection using a dispersive spectrometer (830 nm wavelength, 300 mW laser power and 20 s exposure time). Spectra were then submitted to Principal Components Analysis. The PCA loading vectors 1 and 3 revealed spectral features of urea/creatinine and glucose, respectively; the PCA scores showed that patients with diabetes/hypertension (LG and HG) had higher amount of glucose in the urine compared to the normal group (p diabetes/hypertension (p diabetes/hypertension, can lead to early diagnostic information of complications and a possible disease prognosis in the patients where no complications from diabetes and hypertension were found.

  18. Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: A population study

    Energy Technology Data Exchange (ETDEWEB)

    Swaddiwudhipong, Witaya, E-mail: swaddi@hotmail.com [Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110 (Thailand); Mahasakpan, Pranee [Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110 (Thailand); Limpatanachote, Pisit; Krintratun, Somyot [Department of Internal Medicine, Mae Sot General Hospital, Tak (Thailand)

    2010-08-15

    Risk for hypertension and diabetes has not been conclusively found to be a result of cadmium exposure. A population-based study was conducted in 2009 to examine the correlations of urinary cadmium, a good biomarker of long-term cadmium exposure, with hypertension and diabetes in persons aged 35 years and older who lived in the 12 cadmium-contaminated rural villages in northwestern Thailand. A total of 5273 persons were interviewed and screened for urinary cadmium, hypertension, and diabetes. The geometric mean level of urinary cadmium for women (2.4{+-}2.3 {mu}g/g creatinine) was significantly greater than that for men (2.0{+-}2.2 {mu}g/g creatinine). Hypertension was presented in 29.8% of the study population and diabetes was detected in 6.6%. The prevalence of hypertension significantly increased from 25.0% among persons in the lowest tertile of urinary cadmium to 35.0% in the highest tertile. In women, the rate of hypertension significantly increased with increasing urinary cadmium levels in both ever and never smokers, after adjusting for age, alcohol consumption, body mass index, and diabetes. In men, such association was less significantly found in never smokers. The study revealed no significant association between urinary cadmium and diabetes in either gender. Our study supports the hypothesis that environmental exposure to cadmium may increase the risk of hypertension. Risk for diabetes in relation to cadmium exposure remains uncertain in this exposed population.

  19. Response of fibroblast growth factor 23 to volume interventions in arterial hypertension and diabetic nephropathy.

    Science.gov (United States)

    Humalda, Jelmer K; Seiler-Muler, Sarah; Kwakernaak, Arjan J; Vervloet, Marc G; Navis, Gerjan; Fliser, Danilo; Heine, Gunnar H; de Borst, Martin H

    2016-11-01

    Fibroblast growth factor 23 (FGF-23) rises progressively in chronic kidney disease and is associated with adverse cardiovascular outcomes. FGF-23 putatively induces volume retention by upregulating the sodium-chloride cotransporter (NCC). We studied whether, conversely, interventions in volume status affect FGF-23 concentrations.We performed a post hoc analysis of 1) a prospective saline infusion study with 12 patients with arterial hypertension who received 2 L of isotonic saline over 4 hours, and 2) a randomized controlled trial with 45 diabetic nephropathy (DN) patients on background angiotensin-converting enzyme -inhibition (ACEi), who underwent 4 6-week treatment periods with add-on hydrochlorothiazide (HCT) or placebo, combined with regular sodium (RS) or low sodium (LS) diet in a cross-over design. Plasma C-terminal FGF-23 was measured by ELISA (Immutopics) after each treatment period in DN and before and after saline infusion in hypertensives.The patients with arterial hypertension were 45 ± 13 (mean ± SD) years old with an estimated glomerular filtration rate (eGFR) of 101 ± 18 mL/min/1.73 m. Isotonic saline infusion did not affect FGF-23 (before infusion: 68 median [first to third quartile: 58-97] relative unit (RU)/mL, after infusion: 67 [57-77] RU/mL, P = 0.37). DN patients were 65 ± 9 years old. During ACEi + RS treatment, eGFR was 65 ± 25 mL/min/1.73 m and albuminuria 649 mg/d (230-2008 mg/d). FGF23 level was 94 (73-141) RU/mL during ACEi therapy. FGF-23 did not change significantly by add-on HCT (99 [74-148] RU/mL), LS diet (99 [75-135] RU/mL), or their combination (111 [81-160] RU/mL, P = 0.15).Acute and chronic changes in volume status did not materially change FGF-23 in hypertensive patients and DN, respectively. Our data do not support a direct feedback loop between volume status and FGF-23 in hypertension or DN.

  20. Diabetes, hypertension and mobility among Brazilian older adults: findings from the Brazilian National Household Sample Survey (1998, 2003 and 2008).

    Science.gov (United States)

    Nascimento, Clarissa de Matos; Mambrini, Juliana Vaz de Melo; de Oliveira, Cesar Messias; Giacomin, Karla Cristina; Peixoto, Sérgio Viana

    2015-06-27

    The rapid population ageing has been accompanied by a growing number of older adults experiencing chronic conditions, especially diabetes and hypertension, which are conditions associated to the decline in physical functioning. The aim of this study was to investigate changes in the strength of the association between mobility and two chronic conditions (hypertension and diabetes) in a large representative sample of Brazilian older adults over a ten year period. The data came from the Brazilian National Household Sample Survey (PNAD) of 1998, 2003 and 2008. The sample comprised 28,943 participants aged 60 years and older investigated in 1998, 35,042 in 2003 and 41,269 in 2008, totalling 105,254 older adults. The dependent variable was the physical mobility index (PMI) constructed based on the Item Response Theory (IRT) using five physical mobility indicators. The chronic conditions were self-reported and the confounders included: age, sex, schooling, ethnicity, family income, household composition, other co-morbidities and use of health services. The association between physical mobility (three different groups) and chronic conditions (hypertension and diabetes) was performed using multinomial logistic regression. Over the ten year period the prevalence of hypertension increased from 44 % (1998), 49 % (2003) to 53 % (2008) (p hypertension and diabetes over the ten year period, the decrease in strength of the association with physical mobility during the first period could be explained by improvements in health services and treatment of older adults. Special attention should be given to the treatment and management of diabetes in order to avoid declines in physical mobility levels.

  1. Prevalence of Anemia, Overweight/Obesity, and Undiagnosed Hypertension and Diabetes among Residents of Selected Communities in Ghana

    Directory of Open Access Journals (Sweden)

    Alex Kojo Anderson

    2017-01-01

    Full Text Available The increasing numbers of lifestyle related chronic diseases in developing countries call for awareness, early detection, and effective management. The objective of this paper is to report the prevalence of undiagnosed hypertension, diabetes, overweight/obesity, and anemia among residents of selected communities in Ghana. The data comes from a community screening conducted in Ghana as part of the University of Georgia Summer Service Learning Program. Descriptive statistics were used to summarize the data while chi-square and independent t-test compared groups. A total of 976 participants (37.9% males and 62.1% females, 18 years and older, were screened. Mean age was 46.25±17.14 years, BMI was 25.44±5.26 kgm−2, and hemoglobin was 12.04±2.22 g/dL. 3.1% and 12.6% reported existing diagnosis for diabetes and hypertension, respectively. Almost half (47.8% were overweight/obese; 27.0% were hypertensive while 34.0% had diabetes. Also, 28.8% males compared to 37.8% females had diabetes (P=0.015, while 28.2% males compared to 26.2% females were hypertensive (P=0.635. There were differences in BMI (P<0.0001, anemia (P=0.007, and undiagnosed diabetes (P<0.0001 and hypertension (P<0.0001 by community (Takoradi versus Cape Coast where the screening took place. Findings from the screening exercise call for improved public health education with a focus on lifestyle habits and health seeking behaviors among Ghanaians.

  2. High Prevalence of Obesity, Hypertension, Hyperlipidemia, and Diabetes Mellitus in Japanese Outpatients with Schizophrenia: A Nationwide Survey.

    Science.gov (United States)

    Sugai, Takuro; Suzuki, Yutaro; Yamazaki, Manabu; Shimoda, Kazutaka; Mori, Takao; Ozeki, Yuji; Matsuda, Hiroshi; Sugawara, Norio; Yasui-Furukori, Norio; Minami, Yoshitake; Okamoto, Kurefu; Sagae, Toyoaki; Someya, Toshiyuki

    2016-01-01

    Patients with schizophrenia have significantly shorter life expectancy than the general population, and a problem they commonly face is an unhealthy lifestyle, which can lead to obesity and metabolic syndrome. There is a very clear need to determine the prevalence of obesity, hypertension, hyperlipidemia, and diabetes mellitus which are components of metabolic syndrome in patients with schizophrenia, but there has been a paucity of large-scale studies examining this situation in Japan. The aim of our study was to address this need. We conducted a large-scale investigation of the prevalence of obesity, hypertension, hyperlipidemia, and diabetes mellitus using a questionnaire in 520 outpatient facilities and 247 inpatient facilities of the Japan Psychiatric Hospitals Association between January 2012 and July 2013. There were 7,655 outpatients and 15,461 inpatients with schizophrenia. The outpatients had significantly higher prevalence of obesity, hypertension, hypertriglyceridemia, hyper-LDL cholesterolemia, and diabetes mellitus than the inpatients. The prevalence of hypo-HDL cholesterolemia was higher in inpatients than outpatients. Age-specific analysis showed the prevalence of obesity, hypertension, hypertriglyceridemia, hyper-LDL cholesterolemia, and diabetes mellitus among outpatients to be 2- to 3-fold higher than among inpatients. In individuals aged ≥60 years, the prevalence of obesity and DM among outpatients was about 3-fold higher than among inpatients. Japanese outpatients with schizophrenia were more likely to have physical risk such as obesity, hypertension, hyperlipidemia, and diabetes mellitus than inpatients. The physical risk to patients with schizophrenia may be affected by environmental parameters, such as type of care. The physical risk to Japanese patients with schizophrenia demands greater attention.

  3. Stable fetal hemodynamics measured by Doppler flow after initiation of anti-hypertensive treatment with methyldopa in pregnant women with diabetes

    DEFF Research Database (Denmark)

    Pedersen, Berit Woetmann; Ringholm, Lene; Damm, Peter

    2016-01-01

    AIM: To evaluate whether initiation of anti-hypertensive treatment with methyldopa affects fetal hemodynamics in women with pregestational diabetes. METHODS: Prospective study of unselected singleton pregnant women with diabetes (seven type 1 and two type 2 diabetes), normal blood pressure...

  4. Layer-specific deformation of the left ventricle in uncomplicated patients with type 2 diabetes and arterial hypertension.

    Science.gov (United States)

    Tadic, Marijana; Cuspidi, Cesare; Vukomanovic, Vladan; Ilic, Sanja; Obert, Philippe; Kocijancic, Vesna; Celic, Vera

    2018-01-01

    Detailed analysis of layer-specific mechanical changes in patients with type 2 diabetes mellitus (DM) might improve insight into left ventricular (LV) remodelling and diabetic cardiomyopathy. We sought to investigate layer-specific LV deformation in patients with DM, with and without hypertension. This cross-sectional study included 146 subjects (44 controls; 48 patients with DM; 54 patients with DM and hypertension) who underwent complete examination by two-dimensional echocardiography (2DE), including multilayer strain analysis. 2DE LV longitudinal and circumferential strains deteriorated progressively and significantly from controls, through patients with DM, to patients with DM and hypertension. 2DE radial strain was lower in patients with DM and hypertension than in controls. 2DE longitudinal and circumferential mid-myocardial and epicardial layer strains decreased progressively from controls to patients with DM and hypertension, whereas endocardial layer strain was lower in patients with DM and patients with DM and hypertension than in controls. Variables of DM control (fasting glucose and glycated haemoglobin) were associated with 2DE LV longitudinal and circumferential layer-specific strains, independent of age, body mass index, blood pressure, LV diastolic function and hypertrophy in patients with DM. DM and hypertension significantly affect LV deformation assessed by 2DE traditional strain and 2DE multilayer strain. Hypertension showed an additional negative effect on LV deformation in patients with DM. Fasting glucose and glycated haemoglobin were associated with LV mechanics evaluated by comprehensive 2DE strain analysis, independent of LV structure and diastolic function. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Prevalence of obesity and systemic hypertension among diabetes mellitus patients attending an out-patient diabetes clinic in a Ghanaian Teaching Hospital.

    Science.gov (United States)

    Mogre, Victor; Abedandi, Robert; Salifu, Zenabankara S

    2014-01-01

    Diabetes Mellitus is now a prevalent disease in both developed and developing countries. Overweight/obesity and hypertension are potential modifiable risk factors for diabetes mellitus and persist during the course of the disease. This study was aimed at reporting the prevalence of overweight/obesity and systemic hypertension and their association to blood glucose levels in persons with diabetes mellitus attending a diabetic clinic in Ghanaian Teaching Hospital. This cross-sectional study was conducted among 100 previously diagnosed diabetes mellitus patients attending a diabetic clinic at the Tamale Teaching Hospital, Ghana. Anthropometric variables of age, weight and height were measured with appropriate instruments, computed into BMI and classified according to WHO classifications. Systolic and diastolic blood pressures were measured by an appropriate instrument and classified by WHO standards. Fasting plasma glucose levels of the study participants were recorded from their personal health folder. All data was analysed by GraphPad prism version 5. In general, 7.0% of the participants were underweight and 32.0% were overweight or obese. The mean±SD weight, height and BMI of the participants were 67.53±13.32, 1.68±0.12 and 24.18±5.32. Twenty-one percent of the studied participants were hypertensive. Mean±SD fasting plasma glucose of 7.94±2.82 was observed among the diabetic patients. As the prevalence of hyperglycaemia was higher among patients aged ≤40 years (88.9% vs. 75.8%), normoglycaemia (11.1% vs. 24.2%) was higher among those over 40 years. The differences were not significant. The prevalence of hyperglycaemia was significantly higher in participants with overweight/obese (0.0% vs. 41.6%, phypertension was found. Hyperglycaemia was more prevalent among overweight/obese participants. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. Diagnoses and nursing Interventions in hypertensive and diabetic individuals according to Orem’s Theory

    Directory of Open Access Journals (Sweden)

    Priscila Camara de Moura

    2015-02-01

    Full Text Available This study aimed to identify the most prevalent nursing diagnoses in hypertensive and diabetic patients in the Family Health Care Unit, according to Orem’s conceptual model. A descriptive study was conducted from April to November 2013, using a nursing assessment based on Orem’s theory and NANDA-I taxonomy. 16 nursing diagnoses were identified on Universal self-care requisites, nine on Health deviation requisites and two on Developmental self-care requisites, the most prevalent being: “Risk for unstable blood glucose level” (60%, “Ineffective self-care management” (50% and “Disposition for improved knowledge” (36.6%. Teaching (83.3% and support/instruction (100% actions were implemented in nursing care planning. It can be concluded that there is a need to implement nursing activities directed to offering education on Family Health practices.

  7. Readability and Suitability of Spanish Language Hypertension and Diabetes Patient Education Materials.

    Science.gov (United States)

    Howe, Carol J; Barnes, Donelle M; Estrada, Griselle B; Godinez, Ignacio

    2016-01-01

    Hispanics who speak Spanish are at risk for low health literacy. We evaluated Spanish language hypertension (HTN) and diabetes mellitus (DM) patient education materials from U.S. federal agency public sector sources using the Suitability of Assessment (SAM) instrument. Mean readability for HTN materials was grade 7.9 and for DM materials was grade 6.6. Mean SAM score for HTN materials was 43.9 and for DM materials was 63.2. SAM scores were significantly better for DM than for HTN materials in overall score, content, graphics, layout, stimulation/motivation, and cultural appropriateness (p Spanish language HTN and DM materials that they use in patient teaching.

  8. Increased dementia risk predominantly in diabetes mellitus rather than in hypertension or hyperlipidemia: a population-based cohort study.

    Science.gov (United States)

    Fan, Yen-Chun; Hsu, Jung-Lung; Tung, Hong-Yi; Chou, Chia-Chi; Bai, Chyi-Huey

    2017-02-06

    The pathophysiology of insulin resistance-induced hypertension and hyperlipidemia might entail differences in dementia risk in cases with hypertension and hyperlipidemia without prior diabetes mellitus (DM). This study investigated whether incident hypertension, incident hyperlipidemia, or both, increased the dementia risk in patients with and without DM. A nationwide retrospective cohort study was conducted. The study sample was obtained from the National Health Insurance Research Database. We enrolled 10,316 patients with a new diagnosis of DM between 2000 and 2002 in the DM cohort. For the same period, we randomly selected 41,264 patients without DM in the non-DM cohort (matched by age and sex at a 1:4 ratio with the DM cohort). Both cohorts were then separately divided into four groups on the basis of incident hypertension or incident hyperlipidemia status. In total, 51,580 patients aged between 20 and 99 years were enrolled. The dementia risk was higher in the DM cohort than in the non-DM cohort (adjusted hazard ratio (HR) = 1.47, 95% confidence interval (CI) = 1.30-1.67, p hyperlipidemia did not significantly increase compared with that in those without hypertension and hyperlipidemia (p = 0.529). Similar results were observed in those with either hypertension (p = 0.341) or hyperlipidemia (p = 0.189). In the non-DM cohort, patients with both hypertension and hyperlipidemia had a higher dementia risk (adjusted HR = 1.33, 95% CI = 1.09-1.63, p = 0.006). The results remained largely unchanged in patients with only hypertension (adjusted HR = 1.22, 95% CI = 1.05-1.40, p = 0.008). However, the dementia risk did not increase significantly in patients with only hyperlipidemia (p = 0.187). The development of hypertension, hyperlipidemia, or both, following a diagnosis of incident diabetes is secondary to diabetes onset and likely mediated through insulin resistance associated with diabetes, which does not further

  9. Herman Bang og seksualitetsproblemet

    DEFF Research Database (Denmark)

    Heede, Dag

    2016-01-01

    Diskussion af Herman Bangs essay: Gedanken zum Sexualitätsproblem og dets receptionshistorie i hhv. Tyskland og Danmark......Diskussion af Herman Bangs essay: Gedanken zum Sexualitätsproblem og dets receptionshistorie i hhv. Tyskland og Danmark...

  10. Arbejdsmarkedsregulering og kollektiv visdom

    DEFF Research Database (Denmark)

    2014-01-01

    Industrial relations forskning, organisering og regulering på arbejdsmarkedet, betingelser for kognition, koordination og kooperation......Industrial relations forskning, organisering og regulering på arbejdsmarkedet, betingelser for kognition, koordination og kooperation...

  11. Dapagliflozin reduces albuminuria in patients with diabetes and hypertension receiving renin-angiotensin blockers.

    Science.gov (United States)

    Heerspink, H J L; Johnsson, E; Gause-Nilsson, I; Cain, V A; Sjöström, C D

    2016-06-01

    To characterize the effect of dapagliflozin on albuminuria and estimated glomerular filtration rate (eGFR) and to determine whether effects on albuminuria were mediated through changes in glycated haemoblogin (HbA1c), systolic blood pressure (SBP), body weight or eGFR. We conducted a post hoc analysis of data pooled from two phase III clinical trials in hypertensive patients with type 2 diabetes (T2DM) on stable angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy, randomly assigned to dapagliflozin 10 mg/day or matched placebo. This analysis included only patients with microalbuminuria or macroalbuminuria at baseline. Patients were randomized to receive dapagliflozin 10 mg (n = 167) or placebo (n = 189). Dapagliflozin resulted in greater 12-week reductions in albuminuria compared with placebo: -33.2% [95% confidence interval (CI) -45.4, -18.2]. The reduction in albuminuria was also present after adjusting for age, sex and changes in HbA1c, SBP, body weight and eGFR: -23.5% (95% CI -37.6, -6.3). There was a decrease in eGFR with dapagliflozin versus placebo that was readily reversed 1 week after last dose. No serious renal-related adverse events were observed in any group. Dapagliflozin was effective in lowering albuminuria in patients with T2DM and hypertension using renin-angiotensin system blockade therapy. Reductions in albuminuria were still present after adjusting for changes in HbA1c, SBP, body weight and eGFR. Dapagliflozin-induced improvements in glycaemic control and reductions in SBP, coupled with other potentially beneficial renal effects, may lead to a reduced long-term renal and cardiovascular risk. © 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  12. Applying a "Big Data" Literature System to Recommend Antihypertensive Drugs for Hypertension Patients with Diabetes Mellitus.

    Science.gov (United States)

    Shu, Jing-Xian; Li, Ying; He, Ting; Chen, Ling; Li, Xue; Zou, Lin-Lin; Yin, Lu; Li, Xiao-Hui; Wang, An-Li; Liu, Xing; Yuan, Hong

    2018-01-07

    BACKGROUND The explosive increase in medical literature has changed therapeutic strategies, but it is challenging for physicians to keep up-to-date on the medical literature. Scientific literature data mining on a large-scale of can be used to refresh physician knowledge and better improve the quality of disease treatment. MATERIAL AND METHODS This paper reports on a reformulated version of a data mining method called MedRank, which is a network-based algorithm that ranks therapy for a target disease based on the MEDLINE literature database. MedRank algorithm input for this study was a clear definition of the disease model; the algorithm output was the accurate recommendation of antihypertensive drugs. Hypertension with diabetes mellitus was chosen as the input disease model. The ranking output of antihypertensive drugs are based on the Joint National Committee (JNC) guidelines, one through eight, and the publication dates, ≤1977, ≤1980, ≤1984, ≤1988, ≤1993, ≤1997, ≤2003, and ≤2013. The McNemar's test was used to evaluate the efficacy of MedRank based on specific JNC guidelines. RESULTS The ranking order of antihypertensive drugs changed with the date of the published literature, and the MedRank algorithm drug recommendations had excellent consistency with the JNC guidelines in 2013 (P=1.00 from McNemar's test, Kappa=0.78, P=1.00). Moreover, the Kappa index increased over time. Sensitivity was better than specificity for MedRank; in addition, sensitivity was maintained at a high level, and specificity increased from 1997 to 2013. CONCLUSIONS The use of MedRank in ranking medical literature on hypertension with diabetes mellitus in our study suggests possible application in clinical practice; it is a potential method for supporting antihypertensive drug-prescription decisions.

  13. Contribution of CDKAL1 rs7756992 and IGF2BP2 rs4402960 polymorphisms in type 2 diabetes, diabetic complications, obesity risk and hypertension in the Tunisian population.

    Science.gov (United States)

    Lasram, Khaled; Ben Halim, Nizar; Benrahma, Houda; Mediene-Benchekor, Sounnia; Arfa, Imen; Hsouna, Sana; Kefi, Rym; Jamoussi, Henda; Ben Ammar, Slim; Bahri, Sonia; Abid, Abdelmajid; Benhamamouch, Soraya; Barakat, Abdelhamid; Abdelhak, Sonia

    2015-01-01

    The insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) and the cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) identified through genome-wide association (GWA) studies have been shown to be associated with Type 2 diabetes in various ethnic groups. In this study, we investigated the association of the rs7756992 of CDKAL1 and the rs4402960 of IGF2BP2 with Type 2 diabetes, diabetic complications (nephropathy, retinopathy and cardiovascular disease), obesity and hypertension in a Tunisian population. A case-control association study including 200 Type 2 diabetes Tunisian patients (World Health Organization criteria) and 208 controls (age ≥40; fasting plasma glucose cardiovascular disease, overweight/obesity and hypertension have been also collected. Genotyping was performed using TaqMan technology. A significant association between the rs4402960 and Type 2 diabetes (OR = 1.86, 95% CI = 1.34-2.58, P obese subjects bearing the T-allele have an increased risk to develop Type 2 diabetes (OR = 2.06, 95% CI = 1.40-3.03, P risk of diabetic nephropathy in patients with diabetes (OR = 0.44, 95% CI = 0.27-0.73, P = 0.001). The present study confirms that the rs4402960 of IGF2BP2 gene is a strong candidate for Type 2 diabetes susceptibility and overweight/obesity risk in the Tunisian population. Interestingly, our data suggest that the rs7756992 of CDKAL1 gene have a protective effect against diabetic nephropathy. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  14. Samspillet mellom arv og miljø i etiologien til type 1 diabetes. Et subprosjekt i nyfødtkohort-studien

    Directory of Open Access Journals (Sweden)

    Kjersti Skjold Rønningen

    2009-10-01

    Full Text Available Målet for Norsk Nyfødt-Kohort er bedre helse for mor og barn. Det planlegges en separat undersøkelse forå identifisere nyfødte som har spesielt stor sjanse for å få type 1 diabetes sammenliknet med andre barn.Kun 4 av 100 nyfødte har høy arvelig risiko for type 1 diabetes. Det planlegges at slike barn skal fåtilbud om oppfølgning med regelmessige undersøkelser frem til de er 15 år. På denne måten vil tegn tiltype 1 diabetes kunne oppdages på et så tidlig tidspunkt at det kan være mulig å forebygge sykdommen.Samtidig vil oppfølgning av en genetisk høyrisikogruppe kunne fortelle hva det er som gir startskuddet tilødeleggelse av de insulinproduserende celler.

  15. Motorvejen, byudviklingen og governance

    DEFF Research Database (Denmark)

    Hansen, Carsten Jahn; Nielsen, Thomas Alexander Sick; Harder, Henrik

    2006-01-01

    , interesseorganisationer og borgere, men ofte også internt i politisk-administrative organisationer. Traditionelle top-down og hierarkisk orienterede forvaltninger og organisationer har ofte svært ved at håndtere sådanne problemer, og som konsekvens heraf ses en fremvækst af nye fora og samarbejdsrelationer, der typisk er...

  16. Videnarbejde og stress

    DEFF Research Database (Denmark)

    Buch, Anders; Andersen, Vibeke; Sørensen, Ole Henning

    . Videnarbejde kan for den enkelte være vejen til selvrealisering og begejstring, men rummer også i sig kimen til stress og udbrændthed. Og det er netop i spændingsfeltet - i kampen - mellem begejstring og belastning, at bogen ser stress i det moderne arbejdsliv, som en uoverensstemmelse mellem ydre krav og...

  17. Sproglig Metode og Analyse

    DEFF Research Database (Denmark)

    le Fevre Jakobsen, Bjarne

    Publikationen indeholder øvematerialer, tekster, powerpointpræsentationer og handouts til undervisningsfaget Sproglig Metode og Analyse på BA og tilvalg i Dansk/Nordisk 2010-2011......Publikationen indeholder øvematerialer, tekster, powerpointpræsentationer og handouts til undervisningsfaget Sproglig Metode og Analyse på BA og tilvalg i Dansk/Nordisk 2010-2011...

  18. Portfolio, refleksion og feedback

    DEFF Research Database (Denmark)

    Hansen, Jens Jørgen; Qvortrup, Ane; Christensen, Inger-Marie F.

    2017-01-01

    Denne leder definerer indledningsvist begrebet portfolio og gør rede for anvendelsesmuligheder i en uddannelseskontekst. Dernæst behandles portfoliometodens kvalitet og effekt for læring og undervisning og de centrale begreber refleksion, progression og feedback præsenteres og diskuteres. Herefter...

  19. [Cardiometabolic and cardiorenal syndromes interactions in Algerian diabetic-hypertensive patient: interest of predictive multi-biomarkers strategy to renal dysfunction].

    Science.gov (United States)

    Zoubiri, Houda; Kacimi, Ghouti; Haffaf, El Mahdi; Oudjit, Brahim; Adjroud, Naima; Koceir, Elhadj-Ahmed

    2015-01-01

    The coexistence of essential hypertension (EH) in type 2 diabetic (T2D) patients greatly enhances chronic kidney disease. To assess the acute renal dysfunction in two cohorts of diabetic-hypertensive subjects. The inaugural pathology for each group is either T2D or EH. The study was undertaken on 506 subjects who were divided in 5 groups according to age and sex: diabetic, hypertensive, diabetic- hypertensive (DH and HD) and healthy groups. Patients were phenotyped regarding their cardiometabolic syndrome (CMS) profile using the NCEP/ATPIII criteria and cardiorenal syndrome (CRS) according to the International kidney foundation. Hypertension was defined as systolic (SBP) and diastolic (DBP) blood pressure ≥ 140/90 mmHg, respectively. Insulin resistance (IR) was assessed by Homa-IR model. Glomerular filtration rate (GFR) by creatinine clearance. CMS and CRS parameters were determined on Cobas®. The SBP and DBP measurements by electronic blood pressure using Omron 705 CP® type. IR was found in all diabetics and hypertensive patients. Dyslipidemia are correlated to % body fat mass accretion in all groups. In DH group, the renal disorder is confirmed by decreased GFR (30%) and increased microalbuminuria (> 30 mg/24h); associated with increased NT-pro BNP and plasma aldosterone depletion. Several biomarkers are necessary to detection kidney disease and renal failure prevention in diabetic patients to hypertensive state. The renal dysfunction was significantly related to T2D-EH disease.

  20. Management of uncontrolled hypertension in a nurse-led clinic compared with conventional care for patients with type 2 diabetes.

    Science.gov (United States)

    Denver, Elizabeth A; Barnard, Maria; Woolfson, Robin G; Earle, Kenneth A

    2003-08-01

    To compare the effectiveness of a nurse-led hypertension clinic with conventional community care in general practice in the management of uncontrolled hypertension in patients with type 2 diabetes. We studied 120 men and women outpatient attendees (61% non-Caucasian) with type 2 diabetes and a seated blood pressure (BP) >or=140/80 mmHg. All patients were being treated for hypertension, and 71% had increased urinary albumin excretion (UAE). Patients were allocated to either a nurse-led hypertension clinic or conventional primary care. The primary outcome measure was a change in systolic BP. Secondary outcome measures were total cholesterol, HDL cholesterol, total triglycerides, HbA(1c), UAE, serum creatinine, and changes in absolute stroke and coronary heart disease (CHD) risk scores. The mean (95% CI) difference in the decrement of systolic BP was 12.6 mmHg (5.9-19.3) (P = 0.000) in favor of the nurse-led group, whose patients were three times more likely to a reach target systolic BP <140 mmHg compared with conventional care (P = 0.003). A significant fall in 10-year CHD (P = 0.004) and stroke risk (P = 0.000) scores occurred only in the nurse-led group. There were no significant differences in the reduction of diastolic BP or any of the other secondary outcome measures at 6 months. Compared with conventional care, a nurse-led hypertension clinic is a more effective intervention for patients with type 2 diabetes and uncontrolled hypertension. A target systolic BP <140 mmHg is more readily achieved and may be associated with significant reductions in 10-year cardiovascular disease risk scores.

  1. Trends in hyperlipidemia and hypertension management in type 2 diabetes patients from 1998–2004: a longitudinal observational study

    Directory of Open Access Journals (Sweden)

    Bilo Henk JG

    2007-09-01

    Full Text Available Abstract Background Lack of treatment initiation or intensification might explain why some patients with type 2 diabetes do not reach target goals. The objective is to assess trends in risk factor treatment, and identify determinants for medication adjustments in patients with uncontrolled hypertension and/or hyperlipidemia. Methods We conducted a cohort study using data from the Zwolle Outpatient Diabetes project Integrated Available Care (ZODIAC-study in The Netherlands. Management of hypertension and hyperlipidemia was assessed yearly from 1998–2004 by measuring the percentage of patients receiving a treatment initiation or intensification among all patients with elevated risk factor levels. Generalized estimating equation analyses were performed. Results During the study period, the percentage of patients with an elevated total cholesterol/high-density lipoproteins ratio (>6 decreased considerably (from 29% to 4% whereas the percentage of hypertensive patients decreased only slightly (≥ 150/85 mmHg; from 58% to 51%. Initiation of lipid-lowering therapy and intensification of antihypertensive therapy was higher in more recent years. However, still two-third of patients with insufficiently controlled blood pressure in 2003 did not receive an initiation or intensification of antihypertensive treatment in the following year. Treatment changes were mainly determined by elevated levels of the corresponding risk factor. We did not observe increased initiation rates for lipid-lowering therapy in patients with both hypertension and hyperlipidemia. Conclusion Hypertension and hyperlipidemia management in type 2 diabetes patients has improved in the past decade but further improvement is possible. Greater effort is needed to stimulate medication adjustments in patients with insufficiently controlled hypertension and combined risk factors.

  2. Social Support, Treatment Adherence and Outcome among Hypertensive and Type 2 Diabetes Patients in Ambulatory Care Settings in southwestern Nigeria.

    Science.gov (United States)

    Adisa, Rasaq; Olajide, Olamide O; Fakeye, Titilayo O

    2017-06-01

    To evaluate available and desired sources and types of social-support among hypertensive and type-2-diabetes (T2D) patients. Associations of medication adherence and clinical outcome with access to most available social-support and medicine affordability were subsequently investigated. Cross-sectional questionnaire-guided interview among 250-hypertensive and 200-T2D patients, and review of medical records to retrieve disease-specific clinical parameters. University College Hospital and Ring-Road State Hospital, Ibadan, southwestern Nigeria. Adults out-patients with hypertension, T2D, and T2D comorbid with hypertension were enrolled, while in-patients were excluded. Family source of support was the most available [hypertensive (225; 90.0%); T2D (174; 87.0%)], but government and non-governmental organisation support were largely desired, with financial support preferred, 233(93.2%) hypertensive and 190(95.0%) T2D, respectively. Adherent hypertensive patients with or without access to family support were (127; 56.4%) versus (18; 72.0%), p=0.135; while for T2D were (103; 59.2%) versus (21; 80.8%), p=0.035. Mean systolic blood pressure of hypertensive and fasting plasma glucose of T2D with access to family and financial support were better than their counterparts without access (p>0.05). Hypertensive (110; 76.4%) and T2D (87; 87.0%) participants who consistently afford medicine expenses had significantly better adherence and outcome (psocial-support system in order to consistently ensure improved outcome. None declared.

  3. Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.

    Directory of Open Access Journals (Sweden)

    Nilay D Shah

    Full Text Available BACKGROUND: Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. METHODS AND FINDINGS: Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40-80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent an event was small across guidelines (6.5-7.6 for males and 6.5-7.5 for females; a larger range of differences were observed for expected cost per event avoided (ranges, $117,269-$157,186 for males and $115,999-$163,775 for females. Australian and U.S. guidelines result in the highest and lowest expected costs, respectively. CONCLUSIONS: International guidelines based on the same evidence and seeking the same goal are similar in their effectiveness; however, there are large differences in expected medication costs.

  4. Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.

    Science.gov (United States)

    Shah, Nilay D; Mason, Jennifer; Kurt, Murat; Denton, Brian T; Schaefer, Andrew J; Montori, Victor M; Smith, Steven A

    2011-01-25

    Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40-80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT) to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent an event was small across guidelines (6.5-7.6 for males and 6.5-7.5 for females); a larger range of differences were observed for expected cost per event avoided (ranges, $117,269-$157,186 for males and $115,999-$163,775 for females). Australian and U.S. guidelines result in the highest and lowest expected costs, respectively. International guidelines based on the same evidence and seeking the same goal are similar in their effectiveness; however, there are large differences in expected medication costs.

  5. Acute hypertensive encephalopathy with widespread small-vessel disease at MRI in a diabetic patient: pathogenetic hypotheses

    Energy Technology Data Exchange (ETDEWEB)

    Cotton, F. [Centre Hospitalier Lyon Sud, Department of Radiology, Pierre Benite (France); Universite Claude-Bernard Lyon-I, CREATIS, UMR CNRS (France); Universite Claude-Bernard Lyon-I, Laboratoire d' Anatomie, Laennec (France); Kamoun, S.; Rety-Jacob, F.; Tran-Minh, V.A. [Centre Hospitalier Lyon Sud, Department of Radiology, Pierre Benite (France); Nighoghossian, N. [Hopital Neurologique et Neurochirurgical, Department of Neurology, Bron (France); Universite Claude-Bernard Lyon-I, CREATIS, UMR CNRS (France); Hermier, M. [Hopital Neurologique et Neurochirurgical, Department of Neuroradiology and MRI, Bron (France); Universite Claude-Bernard Lyon-I, CREATIS, UMR CNRS (France)

    2005-08-01

    We report unusual magnetic resonance imaging (MRI) findings in a diabetic patient with neglected hypertension and hyperglycemia, presenting with seizures and coma. Outcome was fatal despite intensive care. The MRI findings included bilateral insular and temporo-occipital grey and white matter involvement, and numerous, scattered, lacunar-like lesions involving the peripheral and deep white matter, basal ganglia grey matter, and brainstem. Lesions had a low apparent diffusion coefficient, and some enhanced following contrast injection. Hypertensive encephalopathy with widespread and severe acute small-vessel disease was considered. Pathophysiology is discussed. (orig.)

  6. Role of digitalis-like substance in the hypertension of streptozotocin-induced diabetes and simulated weightlessness in rats

    Science.gov (United States)

    Pamnani, M. B.; Chen, S.; Haddy, F. J.; Yuan, C.; Mo, Z.

    1998-01-01

    We have examined the role of plasma Na+-K+ pump inhibitor (SPI) in the hypertension of streptozotocin induced insulin dependent diabetes (IDDM) in reduced renal mass rats. The increase in blood pressure (BP) was associated with an increase in extracellular fluid volume (ECFV), and SPI and a decrease in myocardial Na+,K+ATPase (NKA) activity, suggesting that increased SPI, which inhibits cardiovascular muscle (CVM) cell NKA activity, may be involved in the mechanism of IDDM-hypertension. In a second study, using prolonged suspension resulted in a decrease in cardiac NKA activity, suggesting that cardiovascular deconditioning following space flight might in part result from insufficient SPI.

  7. A 50-year-old Woman with Heart Failure with Type II Diabetes Mellitus and Hypertension as Risk Factors

    OpenAIRE

    Dwiyanti, Febrina

    2014-01-01

    Background. Incidence of and mortality from heart failure is increasing in incidence, prevalence and overall mortality. Hypertension and insulin resistance are important risk factors for the development of heart failure (HF). Case. A 50-year-old woman complains of increasing exertional dyspnoea for the last 1 week and now has dyspnoea at rest. She has a history of hypertension for the last 25 years and type II diabetes mellitus for the last 8 years. On examination her BP is 200/110 mmHg, hear...

  8. Impact of educational group strategy to improve clinical and glycemic parameters in individuals with diabetes and hypertension

    Directory of Open Access Journals (Sweden)

    Danielli Teixeira Lima Favaro

    Full Text Available Objective.To evaluate the impact of an educational group strategy to improve clinical and glycemic parameters in individuals with diabetes and hypertension. Methods. This descriptive prospective study included 172 individuals living in São José do Rio Preto-SP, Brazil, who were enrolled in a well-integrated educational group called HIPERDIA (Record System for Follow-up of Hypertensive and Diabetic Individuals coordinated by a qualified multidisciplinary team. We analyzed sociodemographic, anthropometric, clinical, and laboratory data. Data were collected in the first, fifth, and eighth meeting of the educational group. Results. A total of 68.6% of patients were women, 85.4% were white, 64.0% had an incomplete basic education, 47.7% were retired, 79.7% had been diagnosed with diabetes for 6 or more years, 9.9% were smokers, and 9.9% used alcohol. Individuals' diastolic blood pressure decreased between the fifth and eighth meeting (p<0.05. Between the first and fifth meeting, both fasting glucose levels (p<0.05 and glycated hemoglobin decreased; the latter continue to drop at the fifth and eighth meetings (p<0.001. Anthropometric parameters remained unchanged. Conclusion. The results suggest that an educational group strategy is favorable for controlling diabetes mellitus and hypertension.

  9. Gross Morphological Variation in Preterm Placenta in Gestational Diabetes Mellitus and Pregnancy Induced Hypertension

    Directory of Open Access Journals (Sweden)

    Roxana Ferdousi

    2011-07-01

    Full Text Available Background: Preterm birth is the primary cause of perinatal mortality and morbidity. Recently, it has become a significant issue in public health policies of developing countries. Among the various causes, pregnancy induced hypertension (PIH and Gestational diabetes mellitus (GDM are two important high-risk factors for preterm birth. Again, placenta is a mirror that reflects the well-being of the fetus and continuously undergoes a change in weight, structure, shape and function in order to support the well-being of the fetus. Objective: To make an in-depth analysis on the possible gross morphological changes in preterm placenta in respect of GDM and PIH. Materials and Methods: The study was observational, analytical and cross sectional. The patients under this study were selected from the Obstetric ward of BSMMU and BIRDEM Hospital, from June 2005 to October 2005. A total of sixty-six samples were collected from women during 28 weeks to 36 completed weeks of gestation. Among them, twenty-two samples were from mothers having GDM, twenty-two having PIH and twenty-two belonged to normal pregnancy (control group. The placentas were examined to measure their diameter, thickness, cotyledons number, weight, and volume. Results: In this study, the GDM group showed significantly higher values for the variables of diameter, weight, volume and number of cotyledons as compared to PIH group. On the other hand, the thickness of the placenta showed lower values in GDM group, but the result did not reach a significant level. Conclusion: From the findings of this study, it is difficult to establish a clear-cut correlation about placental changes in diabetic and hypertensive mothers during pregnancy. However, the changes in placental weight, volume and diameter found in gestational diabetic mother may be a long term compensatory mechanism, aiming to secure a sufficient nutrient supply to support the growth of the foetus. So, postnatal examination of the placenta

  10. Does albuminuria correlate with silent myocardial ischemia and delayed heart rate recovery in hypertensive men without diabetes mellitus.

    Science.gov (United States)

    Winata, Johan; Panda, Agnes L; Azis, R Abdul

    2015-06-01

    In diabetes patients, albuminuria has been proven to be an independent predictor for SMI and delayed heart rate recovery (HRR). However, in hypertensive patients without diabetes the correlation is still unclear. To determine the correlation between albuminuria to SMI and delayed HRR in hypertensive patients without diabetes. Fourty consecutive asymptomatic primary hypertensive men, aged 40-60 years, without diabetes were included. They underwent treadmill stress testing (TST) and collection of spot urine to measure albumin urine to creatinine ratio (ACR). SMI and HRR at first, second, and third minute were then recorded. SMI was diagnosed if positive ischemic criteria of TST was met without anginal symptom. Albuminuria and delayed HRR were diagnosed based on the treshold value respectively. SMI was diagnosed in 15 % patients. The prevalence of delayed HRR at the first-, second-, and third-minute after exercise were 60, 80, and 52.5 % respectively. Albuminuria was significantly associated with SMI [OR 13.889 (95 % CI 1.423-135.544), p = 0.014]. ROC curve analysis demonstrated the area under the curve (AUC) = 0.784 [(95 % CI 0.588-0.98), p = 0.028], with subsequent calculated sensitivity, specificity, positive- and negative-predictive value of albuminuria to predict SMI were 83.3, 73.5, 35.7, and 96.2 % respectively. Those were no significant correlation between albuminuria and delayed HRR at first, second, and third minute. Albuminuria is a potential marker for excluding SMI in asymptomatic hypertensive men without diabetes.

  11. [Management of hypertension and diabetes in Primary Care clinical practice: ATENCION study].

    Science.gov (United States)

    Millán Núñez-Cortés, J; de la Figuera von Wichmann, M; Rodríguez de Miguel, M; Orera Peña, M L; Labrador Barba, E; Lería Gelabert, M

    2017-04-01

    Cardiovascular diseases are the main cause of death in the Spanish population. The detection and control of cardiovascular risk factors are fundamental in the prevention of cardiovascular disease. The main objectives of this study are to analyse the attitudes and therapeutic decisions of Primary Care (PC) physicians when treating hypertension (HT) and diabetes mellitus type 2 (DM2), with the aim of establishing the situation and eventually proposing improvement strategies. A national ecological, multicentre, cross-sectional, and descriptive study was conducted in 2013. A questionnaire was used and 1,028 PC physicians took part in the study. A total of 92.9% of the investigators consulted have indicated that they follow the guidelines for evaluation, treatment, and diagnosis of HT, and 91.4% in the case of diabetes. The latter is diagnosed as a casual finding, while HT is diagnosed through active investigation in patients with other risk factors. Combined therapy takes more than 6 months to take effect in patients with HT, and between 8 and 9 months in diabetic patients. The percentage of non-compliance is similar (10-40%) in both pathologies. Around half the physicians questioned considered interaction with the specialist to be good or excellent (46% HT and 57.3% DM2). Clinical practices in PC for HT and DM2 have some basic criteria in common. The interaction with the specialist is good, but there is a considerable margin for improvement. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Maternal hyperinsulinism and glycaemic status in the first trimester of pregnancy are associated with the development of pregnancy-induced hypertension and gestational diabetes.

    LENUS (Irish Health Repository)

    Kayemba-Kay's, Simon

    2013-03-01

    To evaluate the relationships across a range of glucose and insulin measures at 12 weeks of gestation with the development of pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM) and birth size.

  13. Magnitude of diabetes and hypertension among patients with Dry Eye Syndrome at a tertiary hospital of Riyadh, Saudi Arabia – A case series

    Directory of Open Access Journals (Sweden)

    Abdullah Omar Al Houssien

    2017-04-01

    Conclusions: This series in central Saudi Arabia suggests that the magnitude of chronic diseases such as diabetes, hypertension, obesity and dyslipidemia seems to be higher in patients with DES compared to the population.

  14. Low-frequency and low-intensity ultrasound irradiation to the forearm improves an index of arterial stiffness in subjects with type 2 diabetes and hypertension

    Directory of Open Access Journals (Sweden)

    Katsunori Nonogaki

    2017-09-01

    Conclusions: The low-frequency and low-intensity ultrasound irradiation to the forearm for 10 min might be useful as a preventive application for arterial stiffness in subjects with type 2 diabetes and hypertension.

  15. Impact of gestational diabetes mellitus and high maternal weight on the development of diabetes, hypertension and cardiovascular disease: a population-level analysis.

    Science.gov (United States)

    Kaul, P; Savu, A; Nerenberg, K A; Donovan, L E; Chik, C L; Ryan, E A; Johnson, J A

    2015-02-01

    To examine the association between gestational diabetes mellitus (GDM) and high maternal weight and the risk of development of chronic disease. Women with singleton deliveries between April 1999 and March 2010 in Alberta, Canada, were categorized according to pre-pregnancy weight (overweight ≥ 91 kg) and GDM status. Obstetric and neonatal outcomes, as well as the long-term incidence of maternal diabetes, hypertension and cardiovascular disease were examined. Of 240 083 women, 213 765 (89%) had no GDM and were not overweight (reference group), 17 587 (7.3%) were overweight only, 7332 (3%) had GDM only and 1399 (0.6%) had GDM and were overweight. Significant differences in Caesarean section rates, induction rates and birthweight were observed across the four groups. During a median follow-up of 5.3 years, diabetes incidence was 36% in the GDM and overweight, 18.8% in the GDM only, 4.8% in the overweight only and 1.1% in the reference group. With respect to hypertension and cardiovascular disease, the GDM and overweight group had the highest rates (26.8% and 3.1%, respectively) and the reference group had the lowest rates (5.8% and 1.0%, respectively). However, rates were similar in the GDM only (14.9% and 1.9%, respectively) and overweight only groups (14.9% and 1.5%, respectively). Not surprisingly, the presence of both high maternal weight and GDM compounds the risk of developing diabetes. However, the association between overweight alone and GDM alone and hypertension and cardiovascular disease appears similar suggesting a need for effective interventions to manage both these conditions to improve the health of these patients. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  16. Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study.

    Science.gov (United States)

    Li, Shanshan; Zhu, Yeyi; Chavarro, Jorge E; Bao, Wei; Tobias, Deirdre K; Ley, Sylvia H; Forman, John P; Liu, Aiyi; Mills, James; Bowers, Katherine; Strøm, Marin; Hansen, Susanne; Hu, Frank B; Zhang, Cuilin

    2016-06-01

    Women who developed gestational diabetes mellitus represent a high-risk population for hypertension later in life. The role of diet in the progression of hypertension among this susceptible population is unknown. We conducted a prospective cohort study of 3818 women with a history of gestational diabetes mellitus in the Nurses' Health Study II as part of the ongoing Diabetes & Women's Health Study. These women were followed-up from 1989 to 2011. Incident hypertension was identified through self-administered questionnaires that were validated previously by medical record review. Adherence scores for the alternative Healthy Eating Index 2010, the alternative Mediterranean diet, and the Dietary Approaches to Stop Hypertension were computed for each participant. Cox proportional hazard models were used to evaluate the associations between dietary scores and hypertension while adjusting for major risk factors for hypertension. We documented 1069 incident hypertension cases during a median of 18.5 years of follow-up. After adjustment for major risk factors for hypertension, including body mass index, alternative Healthy Eating Index 2010, alternative Mediterranean diet, and Dietary Approaches to Stop Hypertension scores were significantly inversely associated with the risk of hypertension; hazard ratio and 95% confidence interval comparing the extreme quartiles (highest versus lowest) were 0.76 (0.61-0.94; P for linear trend =0.03) for AHEI score, 0.72 (0.58-0.90; P for trend =0.01) for Dietary Approach to Stop Hypertension score, and 0.70 (0.56-0.88; P for trend =0.002) for alternative Mediterranean diet score. Adherence to a healthful dietary pattern was related to a lower subsequent risk of developing hypertension among women with a history of gestational diabetes mellitus. © 2016 American Heart Association, Inc.

  17. Studies of the associations between functional beta2-adrenergic receptor variants and obesity, hypertension and type 2 diabetes in 7,808 white subjects

    DEFF Research Database (Denmark)

    Gjesing, A P; Andersen, G; Burgdorf, K S

    2007-01-01

    Functional and common Arg16Gly and Gln27Glu polymorphisms have been identified in ADRB2, the gene encoding the beta2-adrenergic receptor. These variants have previously been examined for association with obesity, hypertension and diabetes with inconclusive results.......Functional and common Arg16Gly and Gln27Glu polymorphisms have been identified in ADRB2, the gene encoding the beta2-adrenergic receptor. These variants have previously been examined for association with obesity, hypertension and diabetes with inconclusive results....

  18. K022: Effect of combination therapy (ANG II antagonist, valsartan and a calcium channel blocker) in a hypertensive model of diabetic nephropathy

    OpenAIRE

    Allen, T.J.; Davis, B.J.; de Gasparo, M.; Cooper, M.E.

    2017-01-01

    Recently, it has been suggested that in the context of diabetes and hypertension, more aggressive blood pressure targets should be considered. To achieve these levels of blood pressure control, it is likely that combination therapy will need to be used. The present study has explored the role of the addition of either a dihydropyridine or a non-dihydropyridine calcium channel blocker (CCB) to Ang II antagonist based treatment in an experimental model of hypertension and diabetes. The doses ch...

  19. Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma? Insights from a case–control study in Nepal

    OpenAIRE

    Krettek, Alexandra; Shakya-Vaidya, Suraj; Aryal, Umesh Raj; Upadhyay, Madan

    2013-01-01

    Background: Non-communicable diseases (NCDs) such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG). POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepales...

  20. Irbesartan is projected to be cost and life saving in a Spanish setting for treatment of patients with type 2 diabetes, hypertension, and microalbuminuria

    NARCIS (Netherlands)

    Palmer, AJ; Annemans, L; Roze, S; Lapuerta, P; Chen, R; Gabriel, S; Carita, P; Rodby, RA; de Zeeuw, D; Parving, HH; De Alvaro, F

    Objectives. The purpose of this study was to project the cumulative incidence of end-stage renal disease (ESRD), life expectancy, and costs in a Spanish setting of treating patients with diabetes, hypertension, and microalbuminuria with either standard hypertension treatment alone or standard

  1. Loss of arterial and renal nitric oxide bioavailability in hypertensive rats with diabetes: effect of beta-blockers.

    Science.gov (United States)

    Mason, R Preston; Kubant, Ruslan; Jacob, Robert F; Malinski, Peter; Huang, Xiaoyan; Louka, Febee R; Borowiec, Jan; Mizuno, Yoshiko; Malinski, Tadeusz

    2009-11-01

    Endothelial cell (EC) dysfunction contributes to hypertension and mechanisms of atherosclerosis. Agents that improve EC function may provide vascular protection, especially in patients with multiple risk factors. In this study, we examined the effects of beta(1)-selective antagonists, nebivolol and metoprolol, on vascular and renal EC function in spontaneously hypertensive (SH) rats with diabetes. Male SH rats were treated with streptozotocin (STZ) to induce type 2 diabetes, followed by treatment with nebivolol or metoprolol at 2 mg/kg/day (vs. vehicle). After 4 weeks, aortic and glomerular ECs were isolated, stimulated with calcium ionophore (CaI), and assayed for nitric oxide (NO), and peroxynitrite (ONOO(-)) release using amperometric approaches. Glucose and mean blood pressure (BP) levels were significantly elevated in diabetic SH rats. In aortic ECs isolated from diabetic SH rats, NO production decreased by 20% whereas ONOO(-) increased by 16%, an effect linked to NAD(P)H oxidase and endothelial NO synthase (eNOS) uncoupling. Nebivolol treatment reduced glucose and BP levels and restored aortic EC function in diabetic SH rats, as indicated by a 30% increase and 23% decrease in NO and ONOO(-) levels, respectively. The NO/ONOO(-) ratio increased by more than twofold with nebivolol treatment in aortic and glomerular ECs. Despite similar reductions in glucose and mean BP levels, metoprolol had a smaller effect on the NO/ONOO(-) ratio in glomerular ECs but no effect in aortic ECs. Vascular and renal NO was significantly reduced in diabetic hypertensive rats and correlated with metabolic changes. Nebivolol reversed these effects in a manner consistent with enhanced endothelial function.

  2. Effect of integrative naturopathy and yoga in a patient with rheumatoid arthritis associated with type 2 diabetes and hypertension

    Directory of Open Access Journals (Sweden)

    A Mooventhan

    2017-01-01

    Full Text Available A 54-year old married woman was diagnosed with rheumatoid arthritis in 2002, essential hypertension in 2008, type-2 diabetes in 2011 and gangrene over 2nd toe of right foot. She underwent conventional management in private hospitals. Her symptoms, began with moderate to severe pain associated with swelling, stiffness (more in the morning in multiple joints especially over small joints. In July-2014 she visited our college hospital with the complaints of pain, mild swelling and stiffness over multiple joints associated with poor quality of sleep (QOS and quality of life (QOL. Subject received integrative Naturopathy and Yoga therapies (INYT with conventional medicine daily for 10-days. After 10-days, improvements in pain, blood sugar, depression, anxiety, stress, QOS, QOL, blood analysis with normal blood pressure (BP was observed. This suggests that INYT could be considered as an adjuvant to conventional medicine in RA associated with type-2 diabetes and essential hypertension.

  3. Effect of Integrative Naturopathy and Yoga in a Patient with Rheumatoid Arthritis Associated with Type 2 Diabetes and Hypertension.

    Science.gov (United States)

    Mooventhan, A; Shetty, Geetha B

    2017-01-01

    A 54-year old married woman was diagnosed with rheumatoid arthritis in 2002, essential hypertension in 2008, type-2 diabetes in 2011 and gangrene over 2nd toe of right foot. She underwent conventional management in private hospitals. Her symptoms, began with moderate to severe pain associated with swelling, stiffness (more in the morning) in multiple joints especially over small joints. In July-2014 she visited our college hospital with the complaints of pain, mild swelling and stiffness over multiple joints associated with poor quality of sleep (QOS) and quality of life (QOL). Subject received integrative Naturopathy and Yoga therapies (INYT) with conventional medicine daily for 10-days. After 10-days, improvements in pain, blood sugar, depression, anxiety, stress, QOS, QOL, blood analysis with normal blood pressure (BP) was observed. This suggests that INYT could be considered as an adjuvant to conventional medicine in RA associated with type-2 diabetes and essential hypertension.

  4. [Use of anti-hypertensive and anti-diabetic drugs by the elderly: a survey in Belo Horizonte, Minas Gerais State, Brazil].

    Science.gov (United States)

    Gontijo, Mônica de Fátima; Ribeiro, Andréia Queiroz; Klein, Carlos Henrique; Rozenfeld, Suely; Acurcio, Francisco de Assis

    2012-07-01

    Concern over the harmful effects of drug use by the elderly has motivated studies aimed at identifying problems in such utilization. This was a household survey with retirees aged > 60 years living in Belo Horizonte, Minas Gerais State, Brazil, in 2003, who reported having a diagnosis of diabetes and/or hypertension. Quality of anti-hypertensive and anti-diabetic medication was measured by redundancy, combinations of drugs, and inappropriate drugs. Among 283 elderly patients (89%) with self-reported hypertension and use of anti-hypertensive pharmacotherapy, 68.2% were using diuretics and 37.8% ACE inhibitors. Among the 22 (64.7%) self-reported diabetic patients under pharmacotherapy, 45.5% were using insulin and 77.3% oral anti-diabetic agents. Among the 89 self-reported diabetic and hypertensive patients, 80 (90%) were using anti-hypertensive drugs and 51 (57.3%) anti-diabetic agents. The study revealed the use of dose combinations, redundant use, and inappropriate medicines, thus indicating the need to monitor treatment protocols and improve healthcare for elderly patients.

  5. Prevalence, awareness, treatment and control of hypertension in adults with diagnosed diabetes: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV).

    Science.gov (United States)

    Lee, H-S; Lee, S-S; Hwang, I-Y; Park, Y-J; Yoon, S-H; Han, K; Son, J-W; Ko, S-H; Park, Y G; Yim, H W; Lee, W-C; Park, Y-M

    2013-06-01

    We evaluated the prevalence, awareness, treatment and control of hypertension in Korean adults with diagnosed diabetes using nationally representative data. Among subjects aged ≥30 years who participated in the Fourth Korea National Health and Nutrition Examination Survey in 2007 and 2008, a total of 745 subjects (336 men and 409 women) with a previous diagnosis of diabetes mellitus were analyzed. The prevalence of hypertension in adults with diagnosed diabetes was 55.5%. The rates of awareness, treatment and control were 88.0, 94.2, and 30.8%, respectively. Compared with the general population, the prevalence of hypertension in adults with diagnosed diabetes was higher in all age groups in both genders. Factors independently associated with a high prevalence of hypertension included being male, increasing age, single, <9 years of education, the presence of chronic kidney disease risk, hypercholesterolemia (≥240 mg dl(-1)) and high body mass index (≥25 kg m(-2)). Regular medical screening was positively associated with hypertension control, whereas a high triglyceride level (≥150 mg dl(-1)) was inversely associated. A high prevalence and a low control rate of hypertension in adults with diagnosed diabetes suggest that stringent efforts are needed to control blood pressure in diabetic patients.

  6. The spectrum of unhealthy drug use and quality of care for hypertension and diabetes: a longitudinal cohort study

    OpenAIRE

    Kim, Theresa W; Samet, Jeffrey H.; Debbie M Cheng; Bernstein, Judith; Wang, Na; German, Jacqueline; Saitz, Richard

    2015-01-01

    Objectives Although it is well known that addiction is associated with adverse medical consequences, the effects of the spectrum of unhealthy drug use (illicit drug or prescription misuse) on chronic conditions such as hypertension and diabetes are understudied. This study evaluated the associations between measures of drug use (ie, frequency, severity and type) and standard quality metrics for inadequate blood pressure (BP) and blood glucose (BG) control. Design Longitudinal cohort study. Pa...

  7. Effect of Integrative Naturopathy and Yoga in a Patient with Rheumatoid Arthritis Associated with Type 2 Diabetes and Hypertension

    OpenAIRE

    Mooventhan, A; Shetty, Geetha B

    2017-01-01

    A 54-year old married woman was diagnosed with rheumatoid arthritis in 2002, essential hypertension in 2008, type-2 diabetes in 2011 and gangrene over 2nd toe of right foot. She underwent conventional management in private hospitals. Her symptoms, began with moderate to severe pain associated with swelling, stiffness (more in the morning) in multiple joints especially over small joints. In July-2014 she visited our college hospital with the complaints of pain, mild swelling and stiffness over...

  8. Prevalence, Awareness, and Management of Hypertension, Dyslipidemia, and Diabetes Among United States Adults Aged 65 and Older

    OpenAIRE

    McDonald, Margaret; Hertz, Robin P.; Unger, Alan N.; Lustik, Michael B

    2009-01-01

    Background Adults aged 65 and older are disproportionately affected by hypertension, dyslipidemia, and diabetes, which are established risk factors for cardiovascular disease (CVD). Although risk reduction strategies among older adults, including control of CVD risk factors, can lead to a decline in premature CVD morbidity and mortality, the prevalence of these risk factors has generally increased in the past decade among elders and risk factor control rates have been suboptimal. We assess pr...

  9. Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older.

    Science.gov (United States)

    McDonald, Margaret; Hertz, Robin P; Unger, Alan N; Lustik, Michael B

    2009-02-01

    Adults aged 65 and older are disproportionately affected by hypertension, dyslipidemia, and diabetes, which are established risk factors for cardiovascular disease (CVD). Although risk reduction strategies among older adults, including control of CVD risk factors, can lead to a decline in premature CVD morbidity and mortality, the prevalence of these risk factors has generally increased in the past decade among elders and risk factor control rates have been suboptimal. We assess prevalence, awareness, treatment, and control rates among U.S. adults aged 65 and older with respect to hypertension, dyslipidemia, and diabetes and describe predictors associated with awareness and management of these factors. Analysis of nationally representative data collected from adults aged 65 and older (n = 3,810) participating in the National Health and Nutrition Examination Survey 1999-2004. Women have a significantly higher prevalence of hypertension than men (76.6% vs 63.0%) and a significantly lower rate of control when treated pharmacologically (42.9% vs 57.9%). Dyslipidemia prevalence is 60.3% overall, and women are significantly more likely to be aware of their condition than men (71.1% vs 59.1%). Diabetes affects 21.2% of older adults, and 50.9% of prevalent cases are treated pharmacologically. Goal attainment among those treated is problematic for all three conditions-hypertension (48.8%), dyslipidemia (64.9%), and diabetes (50.4%). Having two or more doctor visits annually is associated with goal attainment for dyslipidemia. Knowledge of cardiovascular health in older adults and understanding gender gaps in awareness can help physicians and policymakers improve disease management and patient education programs.

  10. Role of haem oxygenase in the renoprotective effects of soluble epoxide hydrolase inhibition in diabetic spontaneously hypertensive rats.

    Science.gov (United States)

    Elmarakby, Ahmed A; Faulkner, Jessica; Pye, Chelsey; Rouch, Katelyn; Alhashim, Abdulmohsin; Maddipati, Krishna Rao; Baban, Babak

    2013-10-01

    We have shown previously that inhibition of sEH (soluble epoxide hydrolase) increased EETs (epoxyeicosatrienoic acids) levels and reduced renal injury in diabetic mice and these changes were associated with induction of HO (haem oxygenase)-1. The present study determines whether the inhibition of HO negates the renoprotective effect of sEH inhibition in diabetic SHR (spontaneously hypertensive rats). After 6 weeks of induction of diabetes with streptozotocin, SHR were divided into the following groups: untreated, treated with the sEH inhibitor t-AUCB {trans-4-[4-(3-adamantan-1-yl-ureido)-cyclohexyloxy]-benzoic acid}, treated with the HO inhibitor SnMP (stannous mesoporphyrin), and treated with both inhibitors for 4 more weeks; non-diabetic SHR served as a control group. Induction of diabetes significantly increased renal sEH expression and decreased the renal EETs/DHETEs (dihydroxyeicosatrienoic acid) ratio without affecting HO-1 activity or expression in SHR. Inhibition of sEH with t-AUCB increased the renal EETs/DHETEs ratio and HO-1 activity in diabetic SHR; however, it did not significantly alter systolic blood pressure. Treatment of diabetic SHR with t-AUCB significantly reduced the elevation in urinary albumin and nephrin excretion, whereas co-administration of the HO inhibitor SnMP with t-AUCB prevented these changes. Immunohistochemical analysis revealed elevations in renal fibrosis as indicated by increased renal TGF-β (transforming growth factor β) levels and fibronectin expression in diabetic SHR and these changes were reduced with sEH inhibition. Co-administration of SnMP with t-AUCB prevented its ability to reduce renal fibrosis in diabetic SHR. In addition, SnMP treatment also prevented t-AUCB-induced decreases in renal macrophage infiltration, IL-17 expression and MCP-1 levels in diabetic SHR. These findings suggest that HO-1 induction is involved in the protective effect of sEH inhibition against diabetic renal injury.

  11. Aryl hydrocarbon receptor nuclear translocator-like (BMAL1) is associated with susceptibility to hypertension and type 2 diabetes.

    Science.gov (United States)

    Woon, Peng Y; Kaisaki, Pamela J; Bragança, José; Bihoreau, Marie-Thérèse; Levy, Jonathan C; Farrall, Martin; Gauguier, Dominique

    2007-09-04

    Many aspects of physiology and behavior follow a circadian rhythm. Brain and muscle Arnt-like protein-1 (BMAL1) is a key component of the mammalian molecular clock, which controls circadian oscillations. In the rat, the gene encoding Bmal1 is located within hypertension susceptibility loci. We analyzed the SNP distribution pattern in a congenic interval associated with hypertension in the spontaneously hypertensive rat (SHR), and we show that Bmal1 maps close to a region genetically divergent between SHR and its normotensive (Wistar-Kyoto) counterpart. Bmal1 sequencing in rat strains identified 19 polymorphisms, including an SHR promoter variant that significantly affects Gata-4 activation of transcription in transient transfection experiments. A genetic association study designed to test the relevance of these findings in 1,304 individuals from 424 families primarily selected for type 2 diabetes showed that two BMAL1 haplotypes are associated with type 2 diabetes and hypertension. This comparative genetics finding translated from mouse and rat models to human provides evidence of a causative role of Bmal1 variants in pathological components of the metabolic syndrome.

  12. Peculiarities of bariatric impact of Styfimol in patients with type 2 diabetes with obesity and hypertension

    Directory of Open Access Journals (Sweden)

    K.O. Zuiev

    2017-11-01

    Full Text Available Background. The purpose of the study was to eva­luate the impact of treatment with a fixed combination of extract of Garcinia cambogia, chromium picolinate, L-tyrosine, L-carnitine and dry extract of brown algae on anthropometric parameters, as well as the amount of adipose tissue (AT and its distribution revealed by dual energy X-ray absorptiometry in patients with type 2 diabetes with obesity and arterial hypertension. Materials and methods. 53 patients (25 men aged 55.90 ± 2.15 years with type 2 diabetes, arterial hypertension and obesity (body mass index (BMI ≥ 30 kg/m2 were recruited in the study. Results. After 12 weeks of treatment with above-mentioned fixed combination at a dose of 1 capsule 3 times a day, a statistically significant reduction in body weight was observed — by 4.5 ± 0.6 % (P1 = 0.0001 and in BMI — by 4.60 ± 0.59 % (P1 = 0.0001, as well as a decrease in the total amount of AT by 4.16 ± 1.33 % (P1 = 0.003. Reduction in body weight occurred predominantly due to abdominal AT, as evidenced by a statistically significant decrease in the amount of AT in the abdominal compartment by 6.02 ± 10.15 % (P1 = 0.0003, as well as reduced waist circumference in both men and women by 6.73 ± 1.24 % (P1 = 0.0001 and 4.06 ± 0.77 % (P1 = 0.0009, respectively. Conclusions. Therapy with a fixed combination of Garcinia cambogia extract, chromium picolinate, L-tyrosine, L-carnitine and dry extract of brown algae has led to a decrease in body weight, mainly due to decrease of abdominal fat.

  13. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Colosia AD

    2013-09-01

    Full Text Available Ann D Colosia,1 Roberto Palencia,2 Shahnaz Khan1 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Boehringer Ingelheim GmbH, Ingelheim, Germany Background: Hypertension and obesity are known to contribute, directly or indirectly, to the development of long-term complications of type 2 diabetes mellitus (T2DM. Knowing the prevalence of these comorbidities is important for determining the size of the population that may benefit from strategies that reduce blood pressure and weight while controlling blood glucose. Methods: In this systematic literature review, electronic searches of PubMed, Embase, and the Cochrane Library were conducted to identify observational studies of hypertension and/or obesity prevalence in patients with T2DM throughout the world. The searches were limited to studies reported in English from January 1, 2001 to February 16, 2012. Results: From a total of 2,688 studies, 92 observational studies provided prevalence rates for hypertension and/or obesity specifically in adults with T2DM. Fifteen studies of specific subtypes of hypertension or subpopulations with T2DM were subsequently excluded, leaving 78 studies (in 77 articles for inclusion in this article. Of these, 61 studies reported hypertension prevalence, 44 reported obesity prevalence, and 12 reported the prevalence of hypertension with obesity. Most studies had a low risk of bias regarding diagnosis of T2DM (70/78, hypertension (59/69, or obesity (45/47. The continental regions with the most observational studies of hypertension or obesity prevalence were Europe (n = 30 and Asia (n = 26. Hypertension rates typically were high in all regions; most studies presented rates above 50%, and many presented rates above 75%. Obesity rates exceeded 30% in 38 of 44 studies and 50% in 14 of 44 studies, especially those assessing central obesity (based on waist circumference. Among obese adults, hypertension rates were at or above 70% in Asia and above 80% in Europe; rates

  14. Predictive models to assess risk of type 2 diabetes, hypertension and comorbidity: machine-learning algorithms and validation using national health data from Kuwait—a cohort study

    Science.gov (United States)

    Farran, Bassam; Channanath, Arshad Mohamed; Behbehani, Kazem; Thanaraj, Thangavel Alphonse

    2013-01-01

    Objective We build classification models and risk assessment tools for diabetes, hypertension and comorbidity using machine-learning algorithms on data from Kuwait. We model the increased proneness in diabetic patients to develop hypertension and vice versa. We ascertain the importance of ethnicity (and natives vs expatriate migrants) and of using regional data in risk assessment. Design Retrospective cohort study. Four machine-learning techniques were used: logistic regression, k-nearest neighbours (k-NN), multifactor dimensionality reduction and support vector machines. The study uses fivefold cross validation to obtain generalisation accuracies and errors. Setting Kuwait Health Network (KHN) that integrates data from primary health centres and hospitals in Kuwait. Participants 270 172 hospital visitors (of which, 89 858 are diabetic, 58 745 hypertensive and 30 522 comorbid) comprising Kuwaiti natives, Asian and Arab expatriates. Outcome measures Incident type 2 diabetes, hypertension and comorbidity. Results Classification accuracies of >85% (for diabetes) and >90% (for hypertension) are achieved using only simple non-laboratory-based parameters. Risk assessment tools based on k-NN classification models are able to assign ‘high’ risk to 75% of diabetic patients and to 94% of hypertensive patients. Only 5% of diabetic patients are seen assigned ‘low’ risk. Asian-specific models and assessments perform even better. Pathological conditions of diabetes in the general population or in hypertensive population and those of hypertension are modelled. Two-stage aggregate classification models and risk assessment tools, built combining both the component models on diabetes (or on hypertension), perform better than individual models. Conclusions Data on diabetes, hypertension and comorbidity from the cosmopolitan State of Kuwait are available for the first time. This enabled us to apply four different case–control models to assess risks. These tools aid

  15. [Prevalence of age, gender and body weight on the frequency of hypertension and diabetes mellitus in patients hospitalized in cardiology department].

    Science.gov (United States)

    Stryjewski, Piotr J; Januś, Bogdan; Krupa, Ewa; Nessler, Bohdan; Badacz, Leszek; Nessler, Jadwiga

    2011-01-01

    Overweight and obesity are a major medical problems of the twenty-first century. According to the World Health Organization (WHO) in the world are about 1.6 billion people with overweight and at least 400 million adults are obese. The aim of this study was to analyze the effects of age, sex, and selected anthropometric parameters on the incidence of hypertension and diabetes mellitus in patients hospitalized in the cardiology department. The study included 1188 patients aged 18 - 94 years (mean age 66.9 years, SD 13.2), including 610 men (mean age 65.9 years, SD 12.7) and 578 women (mean age 67.9 years, SD 13.7), hospitalized in the Department of Cardiology Specialist Hospital Louis Rydygier in Krakow in 2009. All patients defined age, height and weight. Based on these results calculated body mass index (BMI). All patients were collected history on the prevalence of hypertension and type 2 diabetes mellitus. Then performed a statistical analysis of the incidence of hypertension and diabetes mellitus compared to sex, median age, BMI. In the study population normal blood pressure and hypertension grade 2 occurred significantly more often in men. Grade 3 hypertension occurred significantly more often in women. The median age was 67 years. In the older group occurred more frequently hypertension 2 and Grade 3. Also, diabetes mellitus was more common among older people. In obese people (BMI> 30) and overweight (BMI 25-29.99) occurred significantly more grade 3 hypertension compared to those of normal weight. 1. Diabetes mellitus and hypertension are more common in postmenopausal women compared to men the same age. 2. Obesity and overweight predisposes to hypertension grade 3 and diabetes mellitus.

  16. Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population.

    Science.gov (United States)

    Cheong, Kee Chee; Yusoff, Ahmad F; Ghazali, Sumarni M; Lim, Kuang H; Selvarajah, Sharmini; Haniff, Jamaiyah; Khor, Geok L; Shahar, Suzana; Rahman, Jamalludin Abd; Zainuddin, Ahmad A; Mustafa, Amal N

    2013-03-01

    To determine the optimal cut-offs of BMI for Malaysian adults. Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors. All fourteen states in Malaysia. Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006. The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23.3 to 24.1 kg/m2 for men and from 24.0 to 25.4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased. Our findings indicate that BMI cut-offs of 23.0 kg/m2 in men and 24.0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.

  17. The Effect of an Angiotensin Receptor Blocker on Arterial Stiffness in Type 2 Diabetes Mellitus Patients with Hypertension

    Directory of Open Access Journals (Sweden)

    Ji Hyun Kim

    2011-06-01

    Full Text Available BackgroundHypertension and type 2 diabetes mellitus are major risk factors for cardiovascular disease. This study analyzed the changes in central aortic waveforms and pulse wave velocity as well as related parameters after treatment with valsartan, an angiotensin II type 1 receptor blocker, in patients with type 2 diabetes and hypertension.MethodsWe used pulse wave analysis to measure central aortic waveform in a total of 98 subjects. In 47 of these patients, pulse wave velocity measurements were obtained before and after 12 weeks of treatment with valsartan.ResultsIn the central aortic waveform analysis, the aortic pulse pressure and augmentation index were significantly decreased after valsartan treatment, as was the aortic pulse wave velocity. Factors contributing to the improvement in pulse wave velocity were the fasting blood glucose and haemoglobin A1c levels.ConclusionShort-term treatment with valsartan improves arterial stiffness in patients with type 2 diabetes and hypertension, and the glucose status at baseline was associated with this effect.

  18. Diabetes mellitus activates fetal gene program and intensifies cardiac remodeling and oxidative stress in aged spontaneously hypertensive rats.

    Science.gov (United States)

    Rosa, Camila Moreno; Xavier, Natasha Priscilla; Henrique Campos, Dijon; Fernandes, Ana Angélica Henrique; Cezar, Marcelo Diarcadia Mariano; Martinez, Paula Felippe; Cicogna, Antonio Carlos; Gimenes, Camila; Gimenes, Rodrigo; Okoshi, Marina Politi; Okoshi, Katashi

    2013-10-17

    The combination of systemic arterial hypertension and diabetes mellitus (DM) induces greater cardiac remodeling than either condition alone. However, this association has been poorly addressed in senescent rats. Therefore, this study aimed to analyze the influence of streptozotocin-induced DM on ventricular remodeling and oxidative stress in aged spontaneously hypertensive rats (SHR). Fifty 18 month old male SHR were divided into two groups: control (SHR, n = 25) and diabetic (SHR-DM, n = 25). DM was induced by streptozotocin (40 mg/kg, i.p.). After nine weeks, the rats underwent echocardiography and myocardial functional study in left ventricular (LV) isolated papillary muscle preparations. LV samples were obtained to measure myocyte diameters, interstitial collagen fraction, and hydroxyproline concentration. Gene expression of atrial natriuretic peptide (ANP) and α- and β-myosin heavy chain (MyHC) isoforms was evaluated by RT-PCR. Serum oxidative stress was assessed by measuring lipid hydroperoxide concentration and superoxide dismutase and glutathione peroxidase activities. Student's t test or Mann-Whitney test, p oxidant activity and gene expression of ANP and β/α-MyHC ratio were observed in DM. Diabetes mellitus induces cardiac dilation and functional impairment, increases oxidative stress and activates fetal gene program in aged spontaneously hypertensive rats.

  19. Medication supply, healthcare outcomes and healthcare expenses: longitudinal analyses of patients with type 2 diabetes and hypertension.

    Science.gov (United States)

    Chen, Chi-Chen; Blank, Robert H; Cheng, Shou-Hsia

    2014-09-01

    Patients with chronic conditions largely depend on proper medications to maintain health. This study aims to examine, for patients with diabetes and hypertension, whether the appropriateness of the quantity of drug obtained is associated with favorable healthcare outcomes and lower expenses. This study utilized a longitudinal design with a seven-year follow-up period from 2002 to 2009 under a universal health insurance program in Taiwan. The patients under study were those aged 18 years or older and newly diagnosed with type 2 diabetes or hypertension in 2002. Generalized estimating equations were performed to examine the relationship between medication supply and health outcomes as well as expenses. The results indicate that while compared with patients with an appropriate medication supply, patients with either an undersupply or an oversupply of medications tended to have poorer healthcare outcomes. The study also found that an excess supply of medications for patients with diabetes or hypertension resulted in higher total healthcare expenses. Either an undersupply or an oversupply of medication was associated with unfavorable healthcare outcomes, and that medication oversupply was associated with the increased consumption of health resources. Our findings suggest that improving appropriate medication supply is beneficial for the healthcare system. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Diabetes mellitus, hypertension and albuminuria in rural Zambia: a hospital-based survey.

    Science.gov (United States)

    Rasmussen, Jon B; Thomsen, Jakúp A; Rossing, Peter; Parkinson, Shelagh; Christensen, Dirk L; Bygbjerg, Ib C

    2013-09-01

    To assess albuminuria in rural Zambia among patients with diabetes mellitus only (DM group), hypertension only (HTN group) and patients with combined DM and HTN (DM/HTN group). A cross-sectional survey was conducted at St. Francis Hospital in the Eastern province of Zambia. Albumin-creatinine ratio in one urine sample was used to assess albuminuria. Other information obtained included age, sex, body mass index (BMI), waist circumference (WC), blood pressure (BP), glycosylated haemoglobin (HbA1c ), random capillary glucose, time since diagnosis, medication and family history of DM or HTN. A total of 193 participants were included (DM group: n = 33; HTN group: n = 92; DM/HTN group: n = 68). The participants in the DM group used insulin more frequently as diabetes medication than the DM/HTN group (P < 0.05). Furthermore, the DM group was younger and had lower BMI, WC and BP than the two other groups. In the DM group, HTN group and DM/HTN group, microalbuminuria was found in 12.1%, 19.6% and 29.4% (P = 0.11), and macroalbuminuria was found in 0.0%, 3.3% and 13.2% (P = 0.014), respectively. The urine albumin (P = 0.014) and albumin-creatinine ratio (P = 0.0006) differed between the three groups. This hospital-based survey in rural Zambia found a lower frequency of albuminuria among the participants than in previous studies of patients with DM or HTN in urban sub-Saharan Africa. © 2013 John Wiley & Sons Ltd.

  1. ANTI-COLLAGEN TYPE IV ANTIBODIES AND THE DEVELOPMENT OF MICROVASCULAR COMPLICATIONS IN DIABETIC PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Asparuh G. Nikolov

    2012-11-01

    Full Text Available Background and Aims: Thickening of basement membrane in capillaries and small vessels is a well-known finding and important in the progression of diabetic microangiopathy. Patients with diabetes mellitus and arterial hypertension are at higher risk of vascular disease. Material and methods: To monitor the metabolism of the basement membrane protein collagen type IV (CIV in type 2 diabetes mellitus (T2DM, serum levels of antibodies to CIV (ACIV IgG, IgM and IgA were measured using an ELISA method in 93 patients with type 2 diabetes mellitus and arterial hypertension (AH (mean age 61,4±11,3 years, diabetes duration 9,88±3,12 years; hypertension duration 9,28±4,98. These values were compared to serum antibodies to CIV in 42 age and sex matched controls. Diabetics were divided in two groups according to presence- Group 1 (n=67 or absence- Group 2 (n=26 of microangiopathy. Results: Patients with T2DM and AH showed statistically significant higher levels of ACIV IgG in comparison to healthy controls (0.30±0.12 vs. 0.21±0.08 (p=0.0001. Group 1 showed significantly hihger levels of ACIV IgG than Group 2 (0.32±0.13vs. 0.24±0.08 (p=0.009 and healthy controls (0.32±0.13vs. 0.21±0.08 (p=0.0001. ACIV IgG are statistically significant higher in diabetics with retinopathy than this without (0.33±0.10 vs. 0.26±0.13 (р=0.04. ACIV IgG correlates with diabetes duration (r=0.49; (p=0.0004, retinopathy (r=0.20; (p=0.05 and BMI (r=-0.24; (p=0.05. Serum ACIV IgM and IgA levels in patients with T2DM and AH were lower than these in controls, but the differences are not statistically significant.Conclusion: Our study showed a relationship between elevation of serum levels of ACIV IgG in diabetics and development of microangiopathy.

  2. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease....... The current review summarises the available evidence in this area of research and calls for increased awareness of cardiovascular risk assessment and treatment in patients with psoriasis....

  3. Medier og digital kultur

    DEFF Research Database (Denmark)

    Christiansen, René Boyer; Hestbech, Astrid Margrethe; Jørnø, Rasmus Leth Vergmann

    . I dag er skellet mellem mundtlighed og skriftlighed ikke længere så skarpt, og de nye informationsteknikker som fx smartphone, skype, sociale medier, computerspil, og digitale bøger er allemandseje. Institutionerne og pædagoguddannelsen kan i dag ikke undlade at forholde sig til og i et vist omfang...

  4. Knoldesparkeren, Flottenheimeren og Glatnakken

    DEFF Research Database (Denmark)

    Thykjær, Steen; Bjerre, Henrik Jøker; Hansen, Brian Benjamin

    positioner beskrives og eksemplificeres med typer og personer i dagens Danmark.   I mediesøjlen har vi kendissernes Kong Gulerod, idolerne, nikkedukkerne Line Sofie og Frederik fra "Paradise Hotel" eller flottenheimerne, der fører sig frem i klummer og talkshows, f.eks. i "Mads og monopolet", hvor de...

  5. Om musik og multimedier

    DEFF Research Database (Denmark)

    Knakkergaard, Martin

    1998-01-01

    Artiklen søger, gennem eksemplificering og diskussion, at problematisere forholdet musik og multimedia. Der er ikke tale om et forsøg på at nå til nogen endegyldig afgrænsning og bestemmelse af de karakteristika og betingelser, der kendetegner feltet. Formålet er derimod at belyse og præcisere...

  6. Rusmidler og mundhulen

    DEFF Research Database (Denmark)

    Pedersen, Anne Marie Lynge

    2016-01-01

    Brug og misbrug af euforiserende stoffer udgør et stort problem på verdensplan. Det skader ikke kun de personer, som misbruger lovlige og ulovlige stoffer, men påvirker hele familien, venner og samfundet. Brug og misbrug af euforiserende stoffer er stigende i flere lande og er hvert år skyld i mi...

  7. Elevernes egenproduktion og elevinddragelse

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Holm; Levinsen, Karin Tweddell; Skovbjerg, Helle Marie

    2017-01-01

    Bogen og projektet tager udgangspunkt i forskningstraditioner, der knytter sig til elevers produktion som læringspraksis både i og uden for skolen i en kobling med konstruktivistiske og kollaborative læringsteorier, herunder teorier om formelle og uformelle læreprocesser og videndeling, didaktisk...

  8. Meningsskabelse og meningstab

    DEFF Research Database (Denmark)

    Olsén, Peter; Hagedorn-Rasmussen, Peter

    2008-01-01

    Meningsfulde forandringsprocesser i arbejdslivet kræver, at der skabes rum til at fokusere på både indhold og betingelser i arbejdet. At man mestrer arbejdet, og at arbejde og produkt har kvalitet og nytte, er omdrejningspunkt i en positiv oplevelse af arbejdet - og drivkraft i ny meningsskabelse...

  9. Fagdidaktik og it

    DEFF Research Database (Denmark)

    Bundsgaard, Jeppe

    2017-01-01

    aktionsforskning og design based research. I dag er spørgsmålene de samme, men suppleret af interesse for hvad der fremmer og forhindrer kvalificeret undervisning med it, og hvordan lærere udvikler kompetencer og praksis med it i undervisningen. Også metoderne er de samme, men suppleret af bl...

  10. Subjekter og betydninger

    DEFF Research Database (Denmark)

    Schwartz, Ida

    2003-01-01

    Når den enkelte fortæller sin livshistorie er den individuel og dybt personlig, men i fortællingen om oplevelser, begivenheder og personer sker samtidig en formidling af samfundsmæssige og tidstypiske betydningsstrukturer. Subjektive betydninger er på en og samme tid samfundsmæssigt formede og su...

  11. Tradition og Modernisme

    DEFF Research Database (Denmark)

    Bay, Carl Erik

    artiklen "Tradition og Modernisme" sit syn på konventionelle og moderne former i byplanlægning, arkitektur og design. I denne antologi er "Tradition og Modernisme" genoptrykt og fem forskere analyserer den med forskellige indfaldsvinkler. Den perspektiveres i forhold til PHs filosofiske afsæt i...

  12. Pigebilleder og drengestreger

    DEFF Research Database (Denmark)

    Nielsen, Anne Maj

    Med udgangspunkt i børns tegninger gøres der i bogen rede for børns billedsmæssige udvikling og billedsocialisation, for personlige, lokale og kulturelle betydninger i børns billeder i form af forskellige symbollag samt for ligheder og forskelle i piger og drenges billeder og billedsocialisation....

  13. Etos og offentlighed

    DEFF Research Database (Denmark)

    Hansen, Signe Pildal

    2007-01-01

    Siden avisens og dermed massemediernes gennembrud har fænomenet 'offentlighed' påkaldt sig både filosofiens og social- og medievidenskabernes opmærksomhed. Det de diskuterer, er spørgsmålet om, hvad der virker i og på offentligheden, og hvordan medierne spiller ind i den sammenhæng. I denne artik...

  14. Associations of Fatty Liver Disease with Hypertension, Diabetes, and Dyslipidemia: Comparison between Alcoholic and Nonalcoholic Steatohepatitis

    Directory of Open Access Journals (Sweden)

    Nobuyuki Toshikuni

    2017-01-01

    Full Text Available Alcoholic steatohepatitis (ASH and nonalcoholic steatohepatitis (NASH are representative types of fatty liver disease (FLD and have similar histologic features. In this study, we aimed to compare the associations of the two FLD types with hypertension (HT, diabetes mellitus (DM, and dyslipidemia (DL. A nationwide survey investigating FLD status included 753 Japanese subjects (median age 55 years; male 440, female 313 with biopsy-proven ASH (n=172 or NASH (n=581. We performed a multiple logistic regression analysis to identify the factors associated with HT, DM, or DL. Older age and a higher body mass index were significant factors associated with HT. Older age, female sex, a higher body mass index, advanced liver fibrosis, and the NASH type of FLD (odds ratio 2.77; 95% confidence interval 1.78–4.31; P<0.0001 were significant factors associated with DM. Finally, the NASH type of FLD (odds ratio 4.05; 95% confidence interval 2.63–6.24; P<0.0001 was the only significant factor associated with DL. Thus, the associations of NASH with DM and DL were stronger than those of ASH with DM and DL. In the management of FLD subjects, controlling DM and DL is particularly important for NASH subjects.

  15. Paternal history of diabetes mellitus and hypertension affects the prevalence and phenotype of PCOS.

    Science.gov (United States)

    Cheng, Chen; Zhang, Haolin; Zhao, Yue; Li, Rong; Qiao, Jie

    2015-12-01

    The purpose of the present study is to determine if paternal or maternal history of diabetes mellitus (DM) and hypertension (HT) contributes to the prevalence and phenotype of polycystic ovary syndrome (PCOS). We performed an epidemiologic study about PCOS from four districts in Beijing, China, between 2008 and 2009. Parental histories of DM and HT were collected, and the basic characteristics and serum indices of 123 PCOS patients and 718 non-PCOS controls were tested. The prevalence of a parental history of DM and HT was significantly higher in PCOS patients than non-PCOS women (17.1 % vs. 9.2 % and 42.3 % vs. 26.0 %, P PCOS and non-PCOS patients (odds ratio (OR) = 3.42, 95 % confidence interval (CI) = 1.69-6.91; OR = 2.50, 95 % CI = 1.58-3.93, respectively). A paternal history of both DM and HT was significantly associated with sex hormone-binding globulin, fasting plasma glucose, and fasting insulin levels, the free androgen index, and the homeostatic model assessment-insulin resistance in PCOS patients (P PCOS. PCOS patients with a positive paternal history of both DM and HT have an adverse endocrine and metabolic profile. A paternal history of DM and HT poses a risk to PCOS.

  16. Are hypertension and diabetes mellitus risk factors for pelvic organ prolapse?

    Science.gov (United States)

    Isık, Hatice; Aynıoglu, Oner; Sahbaz, Ahmet; Selimoglu, Refika; Timur, Hakan; Harma, Muge

    2016-02-01

    Pelvic organ prolapse (POP) is an important problem for women with multifactorial etiology. This study aims to determine the role of hypertension (HT) and diabetes mellitus (DM) in POP. The study included 586 women admitted to Bulent Ecevit University Hospital between September 2013 and April 2015 for hysterectomy, comprising 186 patients with POP and 400 patients without. The demographic characteristics, age, body mass index (BMI), obstetrical history, type of delivery, associated medical diseases, and benign gynecological diseases were recorded. HT, DM, or both together were particularly considered as coexisting medical diseases. Median gravida, parity, and live birth numbers were significantly higher in POP patients (4 vs. 3, 3 vs. 2, and 3 vs. 2 respectively, p0.05). There was a significant difference between groups regarding comorbid diseases (p<0.001). Logistic regression analysis for risk factors of POP revealed age, BMI, vaginal parturition, and co-morbidity with HT+DM together significantly increased POP risk (p<0.05). HT+DM together significantly increased risks with OR of 1.9 (1.1-3.16). In addition to multiple factors increasing POP risk, comorbidities as HT+DM together should be considered as risk factors. Patients with these comorbidities should be encouraged to change their lifestyles to prevent POP. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Differences in the management of hypertension, diabetes mellitus and dyslipidemia between obesity classes.

    Science.gov (United States)

    Martínez-St John, D R J; Palazón-Bru, A; Gil-Guillén, V F; Sepehri, A; Navarro-Cremades, F; Orozco-Beltrán, D; Carratalá-Munuera, C; Cortés, E; Rizo-Baeza, M M

    2016-01-01

    We did not find any paper that assessed clinical inertia in obese patients. Therefore, no paper has compared the clinical inertia rates between morbidly and nonmorbidly obese patients. A cross-sectional observational study was carried out. We analysed 8687 obese patients ⩾40 years of age who attended their health-care center for a checkup as part of a preventive program. The outcome was morbid obesity. Secondary variables were as follows: failure in the management of high blood pressure (HBP), high blood cholesterol (HBC) and high fasting blood glucose (HFBG); gender; personal history of hypertension, dyslipidemia, diabetes, smoking and cardiovascular disease; and age (years). We analysed the association between failures and morbid obesity by calculating the adjusted odds ratio (OR). Of 8687 obese patients, 421 had morbid obesity (4.8%, 95% confidence interval (CI): 4.4-5.3%). The prevalence rates for failures were as follows: HBP, 34.7%; HBC, 35.2%; and HFBG, 12.4%. Associated factors with morbid obesity related with failures were as follows: failure in the management of HBP (OR=1.42, 95% CI: 1.15-1.74, P=0.001); failure in the management of HBC (OR=0.73, 95% CI: 0.58-0.91, P=0.004); and failure in the management of HFBG (OR=2.24, 95% CI: 1.66-3.03, Pmanagement for HBP and HFBG, and better management for HBC. It would be interesting to integrate alarm systems to avoid this problem.

  18. Pathogenetic Features of Gastroduodenal Peptic Ulcer Associated with Hypertension and Diabetes Mellitus Type 2

    Directory of Open Access Journals (Sweden)

    I.O. Sitsinska

    2016-03-01

    Full Text Available The development and course of gastroduodenal peptic ulcer are associated with the strains of H.pylori (сagA+ vacA+, сagA+ vacА–, сagA– vacA+, сagA– vacA– that was found in patients in the presence of comorbidity and in its absence. In the group of patients with gastroduodenal peptic ulcer combined with hypertension and diabetes mellitus type 2, сagA+ vacA+ strains were found in 14 individuals (45.16 %, сagA+ vacA– — in 4 (12.9 %, сagA– vacA+ — in 13 (41.43 %, and in patients with gastroduodenal peptic ulcer — in 4 (13.79 %, 8 (27.59 % and 16 (55.17 % persons, respectively. The impact of H.pylori strains is associated with the changes of proteolytic and fibrinolytic activity. Given the comorbidity and the role of strains in the development of underlying disease, there has been revealed a probable reduction in the level of albumin lysis, azocasein lysis and an increase in azocol lysis compared with reduced total fibrinolytic activity, non-enzymatic fibrinolytic enzyme activity and increased enzymatic fibrinolytic activity. The use of baseline anti-Helicobacter pylori therapy and probiotics (Lactobacterium, Bifidobacterium provides a positive result.

  19. Obesity and its Relation With Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions.

    Science.gov (United States)

    Patel, Shivani A; Ali, Mohammed K; Alam, Dewan; Yan, Lijing L; Levitt, Naomi S; Bernabe-Ortiz, Antonio; Checkley, William; Wu, Yangfeng; Irazola, Vilma; Gutierrez, Laura; Rubinstein, Adolfo; Shivashankar, Roopa; Li, Xian; Miranda, J Jaime; Chowdhury, Muhammad Ashique Haider; Siddiquee, Ali Tanweer; Gaziano, Thomas A; Kadir, M Masood; Prabhakaran, Dorairaj

    2016-03-01

    The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among

  20. Results of a hypertension and diabetes treatment program in the slums of Nairobi: a retrospective cohort study.

    Science.gov (United States)

    Werner, Marie E; van de Vijver, Steven; Adhiambo, Mildred; Egondi, Thaddaeus; Oti, Samuel O; Kyobutungi, Catherine

    2015-11-17

    Cardiovascular diseases (CVD) are the world's leading cause of death and their prevalence is rising. Diabetes and hypertension, major risk factors for CVD, are highly prevalent among the urban poor in Africa, but treatment options are often limited in such settings. This study reports on the results of an intervention for the treatment of diabetes and hypertension for adult residents of two slums in Nairobi, Kenya. After setting up two clinics in two slums in Nairobi, hypertension and/or diabetes patients were seen by a clinician monthly. Socio-demographic characteristics and clinical data were collected over a 34-month period. Records were analyzed for 726 patients who visited the clinics at least once to determine clinic attendance and compliance patterns using survival analysis. We also examined changes in systolic blood pressure (SBP), diastolic blood pressure (DBP) and random blood glucose (RBG) during the course of the program. There was poor compliance with clinic attendance as only 3.4% of patients attended the clinics on a regular (monthly) basis throughout the 34-month period. 75% of hypertension patients were not compliant after four visits and 27% of patients had only one clinic visit. Significant reduction of mean SBP and DBP (150.4 mmHg to 141.5 mmHg, P = .003, and 89.3 mmHg to 83.2 mmHg, P < .001) was seen for all patients that stayed in care for at least one year. Establishing a preventative care and treatment system in low resource settings for CVD is challenging due to high dropout rates and non-compliance. Innovative strategies are needed to ensure that benefits of treatment programs are sustained for long-term CVD risk reduction in poor urban populations.

  1. Nocturnal blood pressure is associated with the progression of microvascular complications and hypertension in patients with type 1 diabetes mellitus.

    Science.gov (United States)

    Mateo-Gavira, Isabel; Vílchez-López, Francisco J; García-Palacios, María V; Carral-San Laureano, Florentino; Jiménez-Carmona, Soledad; Aguilar-Diosdado, Manuel

    2016-01-01

    To evaluate relationships between early alterations in blood pressure and the progression of microvascular complications of diabetes in clinically-normotensive patients with type 1 diabetes (T1DM). In a prospective observational study of 85 normotensive T1DM patients without microalbuminuria, blood pressure (BP) was monitored over 24h using the ambulatory blood pressure monitoring (ABPM) system at baseline and 7years later. Development or progression of microalbuminuria, retinopathy and hypertension was evaluated. Initially, 20 patients (24%) were diagnosed with masked hypertension and 31 (37%) with non-dipper pattern as the only pathological findings. At 7years: 1) twenty-seven patients (32%) had progression of retinopathy related to the nocturnal diastolic blood pressure (BPD) (OR:1.122; p=0.034) and final non-dipper pattern (OR:5.857; p=0.005); 2) seven patients (10%) developed microalbuminuria for which nocturnal systolic blood pressure (BPS) was a risk factor (OR:1.129; p=0.007); 3) five of the normotensive patients (9%) progressed to hypertension; historic HbA1c (OR:2.767; p=0.046) and nocturnal BPD (OR:1.243; p=0.046) being the related risk factors. BPD level ≥65mmHg was associated with an increase in progression of retinopathy and hypertension. In T1DM patients there is an elevated prevalence of BP alterations, detected using ABPM. Alterations in nocturnal BP predispose to development/progression of microvascular complications and overt hypertension. Copyright © 2016. Published by Elsevier Inc.

  2. [Evaluation on programs regarding the community-based management of hypertension and type 2 diabetes mellitus patients in eight provinces, China].

    Science.gov (United States)

    Li, Yuan; Ren, Duofu; Ding, Pingfei; Zhang, Qin; Zhang, Juan; Shi, Wenhui; Wu, Jing; Shi, Xiaoming; Liang, Xiaofeng

    2014-01-01

    To understand the situation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers. In eight provinces being selected, a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year. Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information, blood pressure and situation of glucose control. The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6% (urban:17.1%, rural:28.1%, χ² = 27 195.33, P management rates were 61.1% (urban:63.3%, rural:58.6%, χ² = 11.82, P diabetes mellitus patients were 50.3% (urban:62.0%, rural:36.6%, χ² = 329.31, P management service of the hypertension patients and type 2 diabetes mellitus patients were 83.0% (urban:84.7% , rural: 80.7% , χ² = 13.42, P managing hypertension and type 2 diabetes mellitus patients in primary health service centers. Further improvement was expected on rates regarding management, standardized management and control on both blood pressure and glucose.

  3. Evaluation of the chronic disease management program for appropriateness of medication adherence and persistence in hypertension and type-2 diabetes patients in Korea.

    Science.gov (United States)

    Kim, Jung-Ae; Kim, Eun-Sook; Lee, Eui-Kyung

    2017-04-01

    The chronic disease management program (CDMP), a multilevel intervention including copayment reduction and physician incentives, was introduced in 2012 in Korea to improve blood pressure and glycemic control by strengthening the function of clinic as primary care institutions in managing hypertension and diabetes. This study, therefore, aimed to evaluate the effect of CDMP on the appropriateness of medication adherence and persistence in hypertension or type-2 diabetes patients.A pre-post retrospective study was conducted using claims cohort data from 2010 to 2013. Hypertension or type-2 diabetes patients were selected as the CDMP group, while dyslipidemia patients were the control group. Study groups were further categorized as clinic shifters or non-shifters on the basis of whether hospital use changed to clinic use during the study period. Pre-post changes in adherence and persistence were assessed. Adherence was measured by medication possession ratio (MPR) and categorized as under (1.1). Persistence was measured by 12-month cumulative persistence rate.The pre-post change was significantly improved for appropriate-adherence (hypertension, +6.0%p; diabetes, +6.1%p), 12-month cumulative persistence (hypertension, +6.5%p; diabetes, +10.8%p), and over-adherence (hypertension, -5.3%p; diabetes, -2.8%p) only among the shifters in the CDMP group. Among these, patients visiting the same, single clinic showed a significant increase in appropriate-adherence, whereas those who changed their clinics showed a nonsignificant increase. No significant improvement was verified among the non-shifters in the CDMP group.CDMP improved medication adherence and persistence by significantly increasing appropriate-adherence and 12-month cumulative persistence rate in hypertension and type-2 diabetes patients. Particularly, CDMP significantly improved over-adherence, which was associated with increasing healthcare costs and hospitalization risk.

  4. Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site: a qualitative study from Nepal

    Directory of Open Access Journals (Sweden)

    Suraj Shakya-Vaidya

    2014-10-01

    Full Text Available Background: Primary open-angle glaucoma (POAG is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma. Objectives: Anticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care. Design: We conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS, a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach. Results: Although people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men. Conclusion: Although people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health

  5. Modalpartiklers topologi og skopus

    DEFF Research Database (Denmark)

    Theilgaard, Liisa

    deres distribution, betydning og kommunikative funktion og at sætte dem ind i en grammatisk beskrivelsesmodel med udgangspunkt i talesprogsdata fra LANCHART-korpusset ved Center for Sociolingvistiske Sprogforandringsstudier og dialektkorpusset Cordiale ved Afdeling for Dialektforskning. Hansen, Erik...

  6. Strandvejen her og nu

    DEFF Research Database (Denmark)

    Bramsen, Bolette; Smidt, Claus M.

    Fotografisk billedværk om ca. 200 huse på Strandvejen på strækningen fra Charlottenlund til Rungsted. Om husenes historiske udvikling, bygherrer og arkitekter og om deres eksklusive karakter og beliggenhed...

  7. Impact of diabetes on treatment-induced changes in left ventricular structure and function in hypertensive patients with left ventricular hypertrophy. The LIFE study

    DEFF Research Database (Denmark)

    Gerdts, E; Okin, P M; Omvik, P

    2009-01-01

    BACKGROUND AND AIM: Diabetes is associated with left ventricular hypertrophy (LVH) and impaired systolic function in hypertensive patients, but less is known about its impact on LVH regression and functional improvement during antihypertensive treatment. METHODS AND RESULTS: We performed annual...... echocardiography in 730 non-diabetic and 93 diabetic patients (aged 55-80 years) with hypertension and electrocardiographic LVH during 4.8-year losartan- or atenolol-based treatment in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Baseline mean blood pressure (BP) and LV mass did...... shortening (both phypertensive patients with LVH, diabetes is associated with more residual LVH and less improvement in systolic LV function by echocardiography over 4.8 years of antihypertensive treatment....

  8. Comparison of Azelnidipine and Trichlormethiazide in Japanese Type 2 Diabetic Patients with Hypertension: The COAT Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Masahiro Takihata

    Full Text Available This study compared the efficacy and safety of azelnidipine with that of trichlormethiazide in Japanese type 2 diabetic patients with hypertension.In a multicenter, open-label trial, 240 patients with adequately controlled diabetes (HbA1c ≤ 7.0% under lifestyle modification and/or administration of hypoglycemic agents and inadequately controlled hypertension (systolic blood pressure [sBP] ≥ 130 mmHg or diastolic blood pressure [dBP] ≥ 80 mmHg who were being treated with olmesartan were enrolled. Participants were randomly assigned to an azelnidipine group or a trichlormethiazide group and were followed up for 48 weeks. Main outcome measure was the difference in the change in HbA1c levels from the baseline values at 48 weeks between these two groups.Of the 240 subjects that were enrolled, 209 subjects (azelnidipine group: 103 patients, trichlormethiazide group: 106 patients completed this trial. At 48 weeks, the following changes were observed in the azelnidipine and trichlormethiazide groups, respectively: HbA1c levels, 0.19 ± 0.52% and 0.19 ± 0.54%; sBP/dBP, -10.7 ± 9.6/-6.6 ± 6.6 mmHg and -7.1 ± 7.7/-3.3 ± 6.1 mmHg (P < 0.001 for both sBP and dBP. In both groups, dizziness (12 patients [11.7%] and 16 patients [15.1%] and edema (16 patients [15.5%] and 7 patients [6.6%], P = 0.047 were observed during the 48-week follow-up period.Azelnidipine was more effective for controlling blood pressure than trichlormethiazide in Japanese type 2 diabetes patients, whereas trichlormethiazide was more effective for reducing albuminuria than azelnidipine. Both of these agents, however, similarly exacerbated glycemic control in type 2 diabetic patients with hypertension.UMIN 000006081.

  9. Metabolic syndrome, hypertension, and diabetes mellitus after gastric banding: the role of aging and of duration of obesity.

    Science.gov (United States)

    Pontiroli, Antonio E; Alberto, Morabito; Paganelli, Michele; Saibene, Alessandro; Busetto, Luca

    2013-01-01

    Bariatric surgery leads to resolution of arterial hypertension and diabetes mellitus; isolated reports indicate that response to bariatric surgery is lower in aged patients. The aim of this study was to evaluate the role of age and of duration of obesity on the frequency of co-morbidities in morbid obesity, as well as on improvement of co-morbidities. A total of 837 consecutive patients with known duration of obesity, undergoing gastric banding, were considered for this study; they were divided into quartiles of age and of duration of obesity. Presence of co-morbidities (diabetes mellitus, arterial hypertension, metabolic syndrome), metabolic variables (cholesterol and HDL-C, triglycerides, blood glucose), anthropometric variables, and loss of weight during 24 months were considered. Older patients had a higher frequency of co-morbidities; duration of obesity only affected frequency of co-morbidities, but not response to surgery. At logistic regression, duration of obesity had a moderate independent effect on the frequency of diabetes. Older patients lost less weight than younger patients, but diabetes mellitus and arterial hypertension improved to the same extent in patients of different ages, and metabolic syndrome disappeared more in older patients, associated with a greater decrease of blood glucose. Frequency of removal of gastric banding and loss to follow-up were not different in different quartiles of age or in different quartiles of duration of obesity. Older patients, despite lower weight loss, have a response to bariatric surgery that is similar to that of younger patients; age and duration of obesity should not be considered as limits to indications to bariatric surgery. Copyright © 2013 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  10. The effect of hypertension and diabetes management in Southwest China: a before- and after-intervention study.

    Directory of Open Access Journals (Sweden)

    Xiaohua Liang

    Full Text Available BACKGROUND: Non-communicable diseases are leading causes of disease burden in middle income countries. Little evidence exists to determine if the primary healthcare system can effectively manage non-communicable diseases. The purpose of this study was to examine the effectiveness of hypertension and diabetes management by the primary healthcare system. METHODS: We used individual level data from the 2009 National Basic Public Health Services System to assess the effectiveness of hypertension and diabetes interventions on fasting plasma glucose, and blood pressure. We analyzed the associations between fasting plasma glucose, systolic or diastolic blood pressure and risk factors. The estimated average intervention effect on data balanced with confounding variables was assessed. RESULTS: 9543 individuals who had data for fasting plasma glucose, systolic blood pressure and diastolic blood pressure were included in this analysis. This study included 6681 patients with hypertension and 2222 with diabetes. The intervention lowered mean fasting plasma glucose by 0.5 mmol/L (0.4-0.6, lowered mean systolic blood pressure by 3.5 mm Hg (3.2-3.7, and lowered diastolic blood pressure by 2.9 mm Hg (2.7-3.2. Individuals who received medicinal treatment had 1.3 mmHg (0.8 to 1.8, P<0.01 lower diastolic blood pressure and 0.6 mmol/L (0.5-0.8, P<0.01 lower fasting plasma glucose than those who did not receive medicine. Generalized linear model indicated that medicinal treatment and baseline systolic blood pressure were significant positive predictors of change in systolic blood pressure. Age, living in urban areas and diabetic complications were significant negative predictors of change for systolic blood pressure. CONCLUSION: The National Basic Public Health Services System in China using trained community healthcare workers and well-established guidelines can be effectively implement non-communicable disease prevention and management care paradigms.

  11. PH og modernismen

    DEFF Research Database (Denmark)

    Ahnfeldt-Mollerup, Merete

    2012-01-01

    Artiklen kaster et kritisk blik på Poul Henningsens samfundsanalyse og dennes sammenhæng med hans design. PH ses i en bredere national og international sammenhæng. Diskussion af designmetoder, æstetik og Bauhaus.......Artiklen kaster et kritisk blik på Poul Henningsens samfundsanalyse og dennes sammenhæng med hans design. PH ses i en bredere national og international sammenhæng. Diskussion af designmetoder, æstetik og Bauhaus....

  12. Ergoterapi og Kulturel rummelighed

    DEFF Research Database (Denmark)

    Flindt, Helle; Skytt, Lisa

    2008-01-01

    Ergoterapeutuddannelsen har en vision om at være kulturel rummelig og har derfor taget initiativ til at undersøge og udarbejde en rapport om kulturmødet mellem uddannelsesinstitution og fler kulturelle studerende.......Ergoterapeutuddannelsen har en vision om at være kulturel rummelig og har derfor taget initiativ til at undersøge og udarbejde en rapport om kulturmødet mellem uddannelsesinstitution og fler kulturelle studerende....

  13. Vision og virkelighed

    DEFF Research Database (Denmark)

    Carlsen, Benny Bang

    Bogen behandler andetsprogsdidaktiske problemstillinger og emner som fx sproglig opmærksomhed, kontrastiv lingvistik, kommunikativ kompetence, andetsprogstilegnelsesteorier, intersprogsanalyse og kulturmødet....

  14. Pressen, personoplysninger og databaser

    DEFF Research Database (Denmark)

    Schaumburg-Müller, Sten

    2006-01-01

    Det undersøges i hvilket omfang persondatalovens til tider meget restriktive og ikke særlig medieegnede regler dækker journalistisk virksomhed, og der redegøres for den særlige regulering af mediers databaser og samspillet med persondataloven og medieansvarsloven......Det undersøges i hvilket omfang persondatalovens til tider meget restriktive og ikke særlig medieegnede regler dækker journalistisk virksomhed, og der redegøres for den særlige regulering af mediers databaser og samspillet med persondataloven og medieansvarsloven...

  15. Kommunikation og organisationsforandring

    DEFF Research Database (Denmark)

    betydning for interven- tion og forandring i organisationer. Fælles for artiklerne er et fokus på relationen mellem kommunikation og organisation som et komplekst samspil mellem den nære interpersonelle kommunikation og de større organisatoriske systemer, som kommu- nikation er indlejret i. Kommunikation og...... organisationsforandring henvender sig til lærere og studerende ved højere læreranstalter samt til konsulenter og ledere i private virksomheder og offentlige institutioner, der beskæftiger sig med forholdet mellem kommunikation og organisation. Den overordnede ide med bogen er at udvikle fagfeltet Interpersonel...

  16. Nonalcoholic Fatty Liver Disease and Associated Metabolic Risks of Hypertension in Type 2 Diabetes: A Cross-Sectional Community-Based Study

    Directory of Open Access Journals (Sweden)

    Xiaoying Ding

    2017-01-01

    Full Text Available The mechanisms facilitating hypertension in diabetes still remain to be elucidated. Nonalcoholic fatty liver disease (NAFLD, which is a higher risk factor for insulin resistance, shares many predisposing factors with diabetes. However, little work has been performed on the pathogenesis of hypertension in type 2 diabetes (T2DM with NAFLD. The aim of this study is to investigate the prevalence of hypertension in different glycemic statuses and to analyze relationships between NAFLD, metabolic risks, and hypertension within a large community-based population after informed written consent. A total of 9473 subjects aged over 45 years, including 1648 patients with T2DM, were enrolled in this cross-sectional study. Clinical and biochemical parameters of all participants were determined. The results suggested that the patients with prediabetes or T2DM were with higher risks to have hypertension. T2DM with NAFLD had significantly higher levels of blood pressure, triglyceride, uric acid, and HOMA-IR than those without NAFLD. Data analyses suggested that hypertriglyceridemia [OR = 1.773 (1.396, 2.251], NAFLD [OR = 2.344 (1.736, 3.165], hyperuricemia [OR = 1.474 (1.079, 2.012], and insulin resistance [OR = 1.948 (1.540, 2.465] were associated with the higher prevalence of hypertension independent of other metabolic risk factors in type 2 diabetes. Further studies are needed to focus on these associations.

  17. Association of obesity with hypertension and type 2 diabetes mellitus in India: A meta-analysis of observational studies.

    Science.gov (United States)

    Babu, Giridhara R; Murthy, G V S; Ana, Yamuna; Patel, Prital; Deepa, R; Neelon, Sara E Benjamin; Kinra, Sanjay; Reddy, K Srinath

    2018-01-15

    To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus (T2DM) in India among adults. To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubMed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevMan version 5 and "metan" command STATA version 11. Heterogeneity was measured by I2 statistic. Funnel plot analysis has been done to assess the study publication bias. Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82 (95%CI: 3.39 to 4.25). The heterogeneity around this estimate (I2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM (OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability. Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.

  18. [Evaluation of blood pressure control by ambulatory blood pressure monitoring and study of factors associated with poor blood pressure control in 300 treated hypertensive type 2 diabetic patients].

    Science.gov (United States)

    Ben-Hamouda-Chihaoui, M; Kanoun, F; Ftouhi, B; Lamine-Chtioui, F; Kamoun, M; Slimane, H

    2011-04-01

    Hypertension is frequently associated with type 2 diabetes and is often difficult to control. Evaluate the frequency of controlled hypertension in our type 2 diabetic patients with known and treated hypertension and determine the factors associated with poor blood pressure control. Prospective study concerning 300 type 2 diabetic patients with a known and treated hypertension, sex-ratio: 0.64, mean age: 61.2±9.1 years (37-86). All subjects underwent physical examination, biological investigations and a 24 hours ambulatory blood pressure monitoring (ABPM). Hypertension was well controlled in 70 patients (23.3%). The concordance rate between clinical measure of blood pressure and ABPM was 70.3%. Subjects with uncontrolled hypertension were older (61.8±8.9 vs 59.1±9.3 years, Pblood pressure rhythm was noted in 239 patients (79.6%) and it was more frequently observed in patients with uncontrolled hypertension (84 vs 66%, PClose monitoring of blood pressure with adjustment of antihypertensive treatment are necessary to improve cardiovascular prognosis of our patients. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. C-reactive protein for predicting prognosis and its gender-specific associations with diabetes mellitus and hypertension in the development of coronary artery spasm.

    Science.gov (United States)

    Hung, Ming-Jui; Hsu, Kuang-Hung; Hu, Wei-Syun; Chang, Nen-Chung; Hung, Ming-Yow

    2013-01-01

    While hypertension is negatively associated with coronary artery spasm (CAS), scarce data are available on diabetes mellitus in relation to CAS. In addition, outcome prediction in patients with CAS is challenging due to the lack of appropriate biomarkers. Therefore, we sought to identify the roles that gender, high-sensitivity C-reactive protein (hs-CRP), diabetes mellitus and hypertension play in CAS development and prognosis. Patients (350 women and 547 men) undergoing diagnostic coronary angiography with or without proven CAS but without obstructive stenosis were evaluated at long-term follow-up (median 102 months). Diabetic women and diabetic men with low hs-CRP levels had a low and high risk of CAS (odds ratio [OR]: 0.16, 95% confidence interval [CI]: 0.01-1.88 and OR: 5.02, 95% CI: 1.03-24.54, respectively). The ORs of CAS in both women and men with the highest hs-CRP tertile (>3 mg/L) reduced from 4.41 to 1.45 and 2.98 to 1.52, respectively, if they had diabetes mellitus, and from 9.68 to 2.43 and 2.60 to 1.75, respectively, if they had hypertension. Hypertension had a more negative effect on CAS development in diabetic than non-diabetic women, which was not observed in men. The highest hs-CRP tertile was an independent predictor of adverse outcomes. Patients with the highest hs-CRP tertile had more coronary events than patients with the lowest hs-CRP tertitle (p = 0.021, log-rank test). Diabetes mellitus contributes to CAS development in men with low hs-CRP levels, but not in women. There are negative effects of diabetes mellitus and hypertension on CAS development in patients with high hs-CRP levels and especially in women. Elevated hs-CRP level independently predicts adverse outcomes.

  20. Sarcopenia is associated with albuminuria independently of hypertension and diabetes: KNHANES 2008-2011.

    Science.gov (United States)

    Han, Eugene; Lee, Yong-Ho; Kim, Gyuri; Kim, So Ra; Lee, Byung-Wan; Kang, Eun Seok; Ahn, Chul Woo; Cha, Bong-Soo

    2016-10-01

    Although sarcopenia is associated with metabolic disorders, its influence on albuminuria has not been determined. The aim of this study was to identify the relationship between sarcopenia and albuminuria in the general population. This was a population-based, cross-sectional study using a nationally representative sample of 2326 subjects aged ≥20years from the Korea National Health and Nutrition Examination Surveys of 2008-2011. Appendicular skeletal muscle (ASM) measured by dual-energy X-ray absorptiometry was used to assess sarcopenia, which was defined as ASM divided by body mass index, as recommended by the international consensus meeting of the National Institutes of Health. Albuminuria was defined as an albumin-to-creatinine ratio of ≥30mg/g using random spot urine samples. A total of 385 (16.5%) subjects were classified as having albuminuria. Sarcopenic subjects showed a higher proportion of albuminuria than subjects without sarcopenia (odds ratios [ORs]=2.17-3.26, all Palbuminuria risk was comparable between insulin-sensitive subjects with sarcopenia and insulin-resistant subjects with preserved muscle mass. A multiple logistic regression analysis also demonstrated that sarcopenia was independently associated with albuminuria (OR=1.61, 95% confidence interval [CI]=1.04-2.48, Palbuminuria remained strong in the elderly population (ORs=1.80-2.68, Palbuminuria was much higher in sarcopenic obese subjects than in other groups (OR=4.90, 95% CI=3.23-7.43, Palbuminuria independent of hypertension, diabetes, and metabolic syndrome. Sarcopenia and obesity had a synergistic impact on the increased risk of albuminuria. This suggests that sarcopenic obesity as well as sarcopenia alone may be considered as novel risk factors for albuminuria. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. A Patient and Provider Research Agenda on Diabetes and Hypertension Management.

    Science.gov (United States)

    Zimmerman, Emily B; Cook, Sarah K; Haley, Amber D; Woolf, Steven H; Price, Sarah K; Berman, Danielle; DeLeire, Thomas; Etz, Rebecca; Khalsa, Jag; Knutson, Kirsten; Kolasa, Kathryn; Krist, Alex; Kuzel, Anton; Lee, Pearl; Nartea, Theresa J; Piatt, Gretchen; Seligman, Hilary; Strom Williams, Joni; Brown, Josh; Early, Jennifer; Hellman, Jill; Karr, Julie; Kervin, Megan; Malik, Isra; Walker, Albert; Goode, Sheila; Gregory, Danita; Herman, Sharon; Kenney, Brenda; Miles, Chimere; Smith, Audrey; White, Travis

    2017-07-01

    A demonstration project in Richmond, Virginia involved patients and other stakeholders in the creation of a research agenda on dietary and behavioral management of diabetes and hypertension. Given the impact of these diseases on morbidity and mortality, considerable research has been directed at the challenges patients face in chronic disease management. The continuing need to understand disparities and find evidence-based interventions to improve outcomes has been fruitful, but disparities and unmet needs persist. The Stakeholder Engagement in Question Development (SEED) method is a stakeholder engagement methodology that combines engagement with a review of available evidence to generate research questions that address current research gaps and are important to patients and other stakeholders. Using the SEED method, patients and other stakeholders participated in research question development through a combination of collaborative, participatory, and consultative engagement. Steps in the process included: (1) identifying the topic and recruiting participants; (2) conducting focus groups and interviews; (3) developing conceptual models; (4) developing research questions; and (5) prioritizing research questions. Stakeholders were involved in the SEED process from February to August 2015. Eighteen questions were prioritized for inclusion in the research agenda, covering diverse domains, from healthcare provision to social and environmental factors. Data analysis took place September to May 2016. During this time, researchers conducted a literature review to target research gaps. The stakeholder-prioritized, novel research questions developed through the SEED process can directly inform future research and guide the development of evidence that translates more directly to clinical practice. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  2. A retrospective review of the medical management of hypertension and diabetes mellitus following sleeve gastrectomy.

    Science.gov (United States)

    Tritsch, Adam M; Bland, Christopher M; Hatzigeorgiou, Christos; Sweeney, Lori B; Phillips, Michael

    2015-04-01

    Bariatric surgery is being performed with increasing frequency in the USA as a definitive treatment for morbid obesity and associated comorbidities. Management strategies of type 2 diabetes mellitus (T2DM) and hypertension (HTN) medications in sleeve gastrectomy (SG) patients postoperatively are unclear, specifically in the immediate postoperative period and 6 months following surgery. From 01 June 2010 to 30 June 2011, at a single military medical facility, a retrospective review of 88 consecutive SG patients was conducted to examine the postoperative medical management of HTN and T2DM. Patient's HTN and T2DM medication regimens were evaluated for 6 months postoperatively. Categorical data was analyzed using chi-square, and continuous data was compared using the Student t test. Statistical analyses were completed with Stata, version 12. Fifty patients were prescribed an average of 2.21 HTN medications at baseline which was reduced to an average of 1.23 (p < 0.01) medications per patient at 1 month. Twenty-four patients received an average of 1.41 oral T2DM medications with a reduction to 0.70 (p < 0.01) on average at 1 month postoperatively. Medication changes persisted throughout the 6-month follow-up. Among T2DM patients requiring insulin therapy, the mean insulin dose was 42.1 units reduced to 16.8 units immediately postoperatively (p < 0.01) which persisted at 1 month. At 6 months, the mean insulin dose was 13.3 units. Medication adjustments for HTN and T2DM made immediately in the postoperative period following SG persisted throughout the 6-month follow-up period and in some patients, required further adjustments.

  3. Differences between patient and physician opinions on adherence to medication for hypertension and diabetes mellitus.

    Science.gov (United States)

    Liguori, Yuji; Murase, Katsuhito; Hamamura, Misako

    2016-09-01

    Non-adherence to prescribed medication presents a barrier to effective treatment. In order to find improved ways of tackling non-adherence, it is important to understand the perspective of both patients and physicians. A web-based survey study was performed to obtain the views and opinions of patients receiving medical treatment for hypertension or diabetes mellitus in Japan, and physicians treating such patients, on adherence to medication. Forty-four percent of both physicians and patients placed great importance on medication adherence, but 11% of patients considered it of low importance. Overall, 85% of patients reported taking their medication correctly. Patients missed a mean of 4.8 or 5.4 daily doses per 30 day prescription based on patient and physician estimates, respectively. Both patients (64%) and physicians (23%) considered the main reason patients forgot to take their medication was that they "inadvertently forgot". Only 1% of physicians said they do not specifically check for residual drugs, but 46% of patients said they do not report missed doses to their doctor. Measures taken by physicians to reduce residual drugs included use of single packs (64%) and reductions in administration frequency (55%); 63% adjusted prescriptions to take account of any remaining drugs. Only 4% of physicians were satisfied with the effectiveness of measures to reduce non-adherence, whereas 59% of patients felt they managed to successfully perform measures to avoid forgetting to take drugs. The study questionnaires were newly developed and did not incorporate validated instruments to assess adherence. Similar proportions of physicians and patients consider medication adherence to be important, but their opinions about measures used to improve adherence differ to some extent. Importantly, almost half of patients do not tell their doctor about missed doses.

  4. Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance.

    Science.gov (United States)

    Proença de Oliveira-Maul, Janaína; Barbosa de Carvalho, Heráclito; Goto, Danielle Miyuki; Maia, Raphaela Mendonça; Fló, Claudia; Barnabé, Viviane; Franco, Denise Reis; Benabou, Simon; Perracini, Monica Rodrigues; Jacob-Filho, Wilson; Saldiva, Paulo Hilário Nascimento; Lorenzi-Filho, Geraldo; Rubin, Bruce K; Nakagawa, Naomi Kondo

    2013-04-01

    We showed previously that nasal mucociliary clearance was decreased in critically ill elderly subjects, most of whom had diabetes mellitus (DM) and/or hypertension (HTN). To determine if these changes were due to the effects of aging, disease, or critical illness, we studied nasal mucociliary clearance and mucus properties in an ambulatory population consisting of young, elderly, and healthy subjects and those with DM, HTN, or both. Of 440 subjects contacted, 252 entered the study. The subjects were divided into the following groups: (1) healthy (n 5 79, 18-94 years, 50 men) and (2) DM and/or HTN, of which 37 had DM (14-90 years, 12 men), 52 had HTN (23-90 years, 12 men), and 84 had both DM and HTN (25-82 years, 33 men). Subjects were also grouped by age: , 40 years, 40 to 59 years, and 60 years. We assessed demographic and clinical data, quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire, nasal mucociliary clearance using the saccharine transit test (STT), and in vitro mucus properties by examining the sneeze (high airflow) clearability and contact angle. A logistic regression analysis for prolonged STT . 12 min was used, and we controlled for age, sex, and diseases. Subjects aged . 60 years reported a decreased SF-36 physical component relative to other age groups. Sex, BMI, BP, heart rate, pulse oximetry, blood glucose level, and mucus properties were not associated with prolonged STT. Aging and DM and/or HTN independently increased the risk of prolonged STT. Aging and DM, HTN, or both diseases are independently associated with decreased nasal mucociliary clearance. This may predispose toward respiratory infections.

  5. Sleep quality and stress in women with pregnancy-induced hypertension and gestational diabetes mellitus.

    Science.gov (United States)

    Hayase, Mako; Shimada, Mieko; Seki, Hiroyuki

    2014-09-01

    Pregnant women with complications including pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM) often experience disrupted sleep patterns because of activation of the sympathetic nervous system. These pathologies are aggravated by sympathetic nervous system activation and may be related to stress. The present study aimed to clarify the characteristics of and changes in sleep quality and stress in pregnant women with PIH and GDM during the second and third trimesters. We enrolled 56 women in their second or third trimesters who were diagnosed with PIH or GDM. Participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS). Secretory immunoglobulin A (SlgA) concentrations were measured as a biological indicator of stress. PSS scores and subjective stress parameters were significantly higher than those reported from previous studies of healthy pregnant women (15.2 points and 15.1 points for the second and third trimesters, respectively). Mean one-day values for SIgA were 168.3 and 205.7 μg/mL for the second and third trimesters, respectively. During the second and third trimesters, SIgA scores were higher than those reported for healthy pregnant women in previous studies. The PSQI component scores sleep disturbance (C5) and sleep duration (C3) in follow up case were significantly higher in the third trimester than in the second trimester. This investigation suggests that pregnant women with PIH and GDM experience higher stress levels than do non-pregnant women and healthy pregnant women. Further, our results indicate that sleep quality worsens during the third trimester compared with the second trimester. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Longitudinal association of hypertension and diabetes mellitus with cognitive functioning in a general 70-year-old population: the SONIC study.

    Science.gov (United States)

    Ryuno, Hirochika; Kamide, Kei; Gondo, Yasuyuki; Kabayama, Mai; Oguro, Ryosuke; Nakama, Chikako; Yokoyama, Serina; Nagasawa, Motonori; Maeda-Hirao, Satomi; Imaizumi, Yuki; Takeya, Miyuki; Yamamoto, Hiroko; Takeda, Masao; Takami, Yoichi; Itoh, Norihisa; Takeya, Yasushi; Yamamoto, Koichi; Sugimoto, Ken; Nakagawa, Takeshi; Yasumoto, Saori; Ikebe, Kazunori; Inagaki, Hiroki; Masui, Yukie; Takayama, Michiyo; Arai, Yasumichi; Ishizaki, Tatsuro; Takahashi, Ryutaro; Rakugi, Hiromi

    2017-07-01

    Both hypertension and diabetes in middle-aged individuals have been suggested to be predictive indicators of cognitive decline. However, the association of hypertension, diabetes and their combination with cognitive functioning is still controversial in older people. The purpose of this study was to investigate the association between cognitive decline and hypertension, diabetes, and their combination in 70-year-old people based on a 3-year longitudinal analysis. Four hundred and fifty-four people aged 70 (±1) years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) were recruited randomly from a general population and were monitored for 3 years. The data, including most of the demographics, cognitive functioning measured by the Montreal Cognitive Assessment Japanese version (MoCA-J), blood pressure, blood chemistry and other medical histories, were collected at baseline and during the follow-up. The prevalence of hypertension noted in the follow-up survey was significantly higher than than noted at baseline. The mean MoCA-J score at follow-up was not significantly different from the score obtained at baseline. However, the participants with diabetes, especially combined with hypertension at baseline, had significantly lower MoCA-J scores than those without lifestyle-related diseases. The combination of hypertension and diabetes was still a significant risk factor for cognitive decline, considering the MoCA-J scores obtained during the follow-up after adjustments at baseline, relative to sex, body mass index, dyslipidemia, smoking, excessive alcohol intake, antihypertensive treatment and education level (β=-0.14; Pdiabetes and the combination of hypertension and diabetes are clear risk factors for future cognitive decline in elderly individuals who are 70 years of age.

  7. Formulation and In Vitro Evaluation of Bilayer Tablets of Nebivolol Hydrochloride and Nateglinide for the Treatment of Diabetes and Hypertension

    Directory of Open Access Journals (Sweden)

    Harika Ryakala

    2015-01-01

    Full Text Available Diabetes mellitus (DM and hypertension are two common diseases that often coexist. The most common cause of death in the diabetic patient is heart disease. In the present investigation we combine Nebivolol and Nateglinide for better patient compliance. IR layer was formulated using various superdisintegrants like Crospovidone, Croscarmellose sodium, and sodium starch glycolate and SR layer was formulated using polymers and gums like HPMC E15, ethyl cellulose, Gaur gum, and Xanthan gum. The disintegration and dissolution study of both layers showed that inclusion of surfactant (sodium lauryl sulphate to the tablet formulation (IR and dissolution medium (SR enhanced the release of drugs from both layers. Kinetic studies of optimized IR layer (NBL8 and SR layer (N9 showed good linearity with regression coefficient of 0.9714 (Higuchi model and 0.9931 (zero order kinetics, respectively. The above results reveal that the optimized IR layer of Nebivolol (NBL8 and SR layer of Nateglinide (N9 might be suitable for the treatment of diabetes and hypertension by sequential release of the two drugs in a bilayer tablet. IR-immediate release, SR-sustain release, NBL8-Nebivolol 8, N9-Nateglinide 9.

  8. Formulation and in vitro evaluation of bilayer tablets of nebivolol hydrochloride and nateglinide for the treatment of diabetes and hypertension.

    Science.gov (United States)

    Ryakala, Harika; Dineshmohan, S; Ramesh, Alluri; Gupta, V R M

    2015-01-01

    Diabetes mellitus (DM) and hypertension are two common diseases that often coexist. The most common cause of death in the diabetic patient is heart disease. In the present investigation we combine Nebivolol and Nateglinide for better patient compliance. IR layer was formulated using various superdisintegrants like Crospovidone, Croscarmellose sodium, and sodium starch glycolate and SR layer was formulated using polymers and gums like HPMC E15, ethyl cellulose, Gaur gum, and Xanthan gum. The disintegration and dissolution study of both layers showed that inclusion of surfactant (sodium lauryl sulphate) to the tablet formulation (IR) and dissolution medium (SR) enhanced the release of drugs from both layers. Kinetic studies of optimized IR layer (NBL8) and SR layer (N9) showed good linearity with regression coefficient of 0.9714 (Higuchi model) and 0.9931 (zero order kinetics), respectively. The above results reveal that the optimized IR layer of Nebivolol (NBL8) and SR layer of Nateglinide (N9) might be suitable for the treatment of diabetes and hypertension by sequential release of the two drugs in a bilayer tablet. IR-immediate release, SR-sustain release, NBL8-Nebivolol 8, N9-Nateglinide 9.

  9. Diabetes, hypertension and hyperlipidemia: prevalence over time and impact on long-term survival after liver transplantation.

    Science.gov (United States)

    Parekh, J; Corley, D A; Feng, S

    2012-08-01

    With increasing short-term survival, the transplant community has turned its focus to delineating the impact of medical comorbidities on long-term outcomes. Unfortunately, conditions such as diabetes, hypertension and hyperlipidemia are difficult to track and often managed outside of the transplant center by primary care providers. We collaborated with Kaiser Permanente Northern California to create a database of 598 liver transplant recipients, which incorporates diagnostic codes along with laboratory and pharmacy data. Specifically, we determined the prevalence of diabetes, hypertension and hyperlipidemia both before and after transplant and evaluated the influence of disease duration as a time-dependent covariate on posttransplant survival. The prevalence of these comorbidities increased steadily from the time of transplant to 7 years after transplant. The estimated risk for all-cause mortality (hazard ratio = 1.07 per year increment, 95% CI 1.01-1.13, p hyperlipidemia. Greater attention to management of diabetes may mitigate its negative impact on long-term survival in liver transplant recipients. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. Choice of ACE inhibitor combinations in hypertensive patients with type 2 diabetes: update after recent clinical trials

    Directory of Open Access Journals (Sweden)

    Gianpaolo Reboldi

    2009-05-01

    Full Text Available Gianpaolo Reboldi1, Giorgio Gentile1, Fabio Angeli2, Paolo Verdecchia2 1Department of Internal Medicine. University of Perugia, Italy; 2Department of Cardiology, Clinical Research Unit ‘Preventive Cardiology’ Hospital ‘Santa Maria della Misericordia’, Perugia, ItalyAbstract: The diabetes epidemic continues to grow unabated, with a staggering toll in micro- and macrovascular complications, disability, and death. Diabetes causes a two- to four-fold increase in the risk of cardiovascular disease, and represents the first cause of dialysis treatment both in the UK and the US. Concomitant hypertension doubles total mortality and stroke risk, triples the risk of coronary heart disease and significantly hastens the progression of microvascular complications, including diabetic nephropathy. Therefore, blood pressure reduction is of particular importance in preventing cardiovascular and renal outcomes. Successful antihypertensive treatment will often require a combination therapy, either with separate drugs or with fixed-dose combinations. Angiotensin converting enzyme (ACE inhibitor plus diuretic combination therapy improves blood pressure control, counterbalances renin-angiotensin system activation due to diuretic therapy and reduces the risk of electrolyte alterations, obtaining at the same time synergistic antiproteinuric effects. ACE inhibitor plus calcium channel blocker provides a significant additive effect on blood pressure reduction, may have favorable metabolic effects and synergistically reduce proteinuria and the rate of decline in glomerular filtration rate, as evidenced by the GUARD trial. Finally, the recently published ACCOMPLISH trial showed that an ACE inhibitor/calcium channel blocker combination may be particularly useful in reducing cardiovascular outcomes in high-risk patients. The present review will focus on different ACE inhibitor combinations in the treatment of patients with type 2 diabetes mellitus and hypertension

  11. Effects of mineralocorticoid receptor antagonists in patients with hypertension and diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Takahashi, S; Katada, J; Daida, H; Kitamura, F; Yokoyama, K

    2016-09-01

    Blood pressure (BP) control is important to ameliorate cardiovascular events in patients with diabetes mellitus (DM). However, achieving the target BP with a single drug is often difficult. The objective of this study was to evaluate the antihypertensive effects of mineralocorticoid receptor antagonists (MRAs) as add-on therapy to renin-angiotensin system (RAS) inhibitor(s) in patients with hypertension and DM. Studies were searched through October 2014 in MEDLINE, Embase and the Cochrane Central Register of Controlled Trials. Randomized, controlled trials or prospective, observational studies regarding concomitant administration of MRA and RAS inhibitor(s) in patients with DM were included. Articles were excluded if the mean systolic BP (SBP) was hypertension and DM already taking RAS inhibitors. Serum potassium levels should be monitored to prevent hyperkalemia.

  12. Do We Need a Patient-Centered Target for Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes Mellitus?

    Science.gov (United States)

    Wan, Eric Yuk Fai; Yu, Esther Yee Tak; Fung, Colman Siu Cheung; Chin, Weng Yee; Fong, Daniel Yee Tak; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen

    2017-12-01

    The current trend on diabetes mellitus management advocates replacing the paradigm from a uniform to an individualized patient-centered systolic blood pressure (SBP), but there is no consensus on the achieved treatment goals of SBP level. The study aimed at evaluating the association between SBP and the risk of cardiovascular diseases (CVD) and all-cause mortality for diabetic patients to identify patient-centered treatment targets. A retrospective study was conducted on 95 086 Chinese adult primary care patients with type 2 diabetes mellitus and hypertension. Using the average of the annual SBP records (updated SBP) over a median follow-up of 5.9 years, the risks of overall CVD, all-cause mortality, and their composite associated with SBP were evaluated using Cox proportional hazards regression. Subgroup analysis was performed on the incidence of CVD by stratifying patient's baseline characteristics. The SBP range for the lowest risk of CVD and all-cause mortality was 130 to 134 mm Hg among type 2 diabetes mellitus population. A J-shaped curvilinear relationship was identified between SBP and risk of CVD and all-cause mortality, irrespective of patients' characteristics. The findings showed that all patients with SBP diabetic management. © 2017 American Heart Association, Inc.

  13. Beta-blockers in the management of hypertension in patients with type 2 diabetes mellitus: is there a role?

    Science.gov (United States)

    Dunne, F; Kendall, M J; Martin, U

    2001-01-01

    It has been conclusively established that treatment of hypertension in patients with type 2 (non-insulin-dependent) diabetes mellitus will significantly reduce the incidence of stroke, heart failure and progression of diabetic complications. Beta-blockers are effective antihypertensive agents which, in long term studies, have proven beneficial in reducing important clinical end-points. However nonselective beta-blockers may have a negative effect on lipid profiles and contribute to hypoglycaemic unawareness, thus preventing their use in some patients with diabetes mellitus. The development of newer and more selective beta-blockers has overcome many of these problems. In addition, some of the newer agents have novel properties such as release of nitric oxide, which theoretically would make them more attractive in patients with diabetes mellitus. Overall, the adverse metabolic effects of beta-blockers do not appear to be important in clinical practice and these agents should no longer be contraindicated in patients with type 2 diabetes mellitus. Their proven cardiovascular benefits would seem to easily tip the balance in favour of their use.

  14. Relationship between chronic complications, hypertension, and health-related quality of life in Portuguese patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Sepúlveda E

    2015-10-01

    Full Text Available Eduardo Sepúlveda,1,2 Rui Poínhos,2,3 Miguel Constante,4,5 José Pais-Ribeiro,1,2 Paula Freitas,6–8 Davide Carvalho6–8 1Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal; 2Associação de Prevenção e Apoio à Diabetes, Porto, Portugal; 3Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; 4Institute of Psychiatry, King's College London, London, UK; 5Department of Psychiatry, Hospital Beatriz Ângelo, Loures, Portugal; 6Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal; 7Faculty of Medicine, University of Porto, Porto, Portugal; 8Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal Background: The aim of this study was to assess the relationship between health-related quality of life (HRQoL and the presence or absence of hypertension and diabetes-related chronic complications in type 2 diabetes, and also the association between HRQoL and the number of chronic complications. Methods: One hundred patients with type 2 diabetes were interviewed. HRQoL was evaluated using the age-adjusted Short-Form 36 dimensions (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Results: The mean age of the study population was 62.7±8.7 years; 54.0% were male, and 51.0% were receiving only oral hypoglycemic agents. Chronic complications were related to worse HRQoL in different dimensions: peripheral neuropathy and cardiovascular disease (all, except bodily pain, retinopathy (physical functioning, general health, vitality, and mental health, peripheral arterial disease (physical functioning, role-physical, and general health, and nephropathy (general health and vitality. Hypertension was related to worse general health and vitality. An increased number of chronic complications was associated with worse HRQoL in all dimensions of Short

  15. Hel igen efter amputation - og vejen dertil

    DEFF Research Database (Denmark)

    Østergaard, Elisabeth Bomholt

    Hel igen efter amputation – og vejen dertil Elisabeth Bomholt Østergaard, PT, Master i sundhedsantropologi, Dip.pæd. Baggrund Sundhedsprofessionelle bør udvikle større opmærksomhed på og forståelse for, hvilke måder mennesker oplever ’inkorporation’ af diverse proteser, som fx pacemaker, benprotese.......000 og 300.000 mennesker type 2- diabetes og forekomsten er kraftigt stigende og forekommer i stadig yngre aldersgrupper (Dansk Sygeplejeråd 2006) med amputation som mulig konsekvens. Formål Opnå indsigt i hvad der kan medvirke til, at mennesker kan føle sig hele igen efter en benamputation, føle sig...... reintegreret i samfundet og opnå et tilfreds-stillende hverdagsliv, kropsforandringers indflydelse på identiteten , rehabilitering i rituel belysning med fokus på kroppens rolle. Metode og materiale To måneders feltarbejde i 2006 i Danmark blandt ni mennesker, som havde fået amputeret en del af et ben, og som...

  16. Urine Levels of Phthalate Metabolites and Bisphenol A in Relation to Main Metabolic Syndrome Components: Dyslipidemia, Hypertension and Type 2 Diabetes. A Pilot Study.

    Science.gov (United States)

    Piecha, Roman; Svačina, Štěpán; Malý, Marek; Vrbík, Karel; Lacinová, Zdenka; Haluzík, Martin; Pavloušková, Jana; Vavrouš, Adam; Matějková, Dagmar; Müllerová, Dana; Mráz, Miloš; Matoulek, Martin

    2016-12-01

    Human exposure to organic pollutants (some of them also called endocrine disruptors) can be associated with adverse metabolic health outcomes including type 2 diabetes. The goal of this study was to compare the urine levels of bisphenol A and phthalate metabolites in subgroups of patients with metabolic syndrome composed of patients with and without three important components of metabolic syndrome (hypertension, dyslipidemia and diabetes). We have investigated 24 hr urine samples of 168 patients with metabolic syndrome from the Metabolic Outpatient Department of General University Hospital in Prague. Using standard metabolic syndrome criteria, we classified patients as dyslipidemic (n=87), hypertensive (n=96), and type 2 diabetic (n=58). Bisphenol A and 15 metabolites of phthalates were evaluated in relation to creatinine excretion. Samples were analysed with enzymatic cleavage of glucuronide using ultra-high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in one laboratory with external quality control. Four metabolites, mono-n-butyl phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, and mono-(2-ethyl-5-carboxypentyl) phthalate showed significantly higher levels in diabetic compared to non-diabetic patients (pbisphenol A level to diabetes, hypertension, dyslipidemia, age, and BMI. Urine levels of four phthalate metabolites were significantly higher in type 2 diabetics independently on specified predictors. Phthalate levels can be in relation to beta cell dysfunction in type 2 diabetic patients but this study is not able to show if the relation is causal.

  17. Health Inequalities in Diabetes Mellitus and Hypertension: A Parish Level Study in the Northern Region of Portugal.

    Science.gov (United States)

    Leao, Teresa; Perelman, Julian; Felício, Manuela; Machado, Vasco; Lima, Graça

    2016-10-01

    Diabetes and hypertension are highly prevalent conditions in Portugal. Little is known about the geographical and social patterning of these diseases, which precludes the design of targeted health policies. This study aimed to measure the geographical and socioeconomic distribution of type 2 diabetes and hypertension prevalence in the population resident in the Northern region of Portugal, for the year 2013. An ecological correlation study analyzed the 2,028 parishes of the region. Prevalence data were obtained from the Regional Health Administration information system. Socioeconomic data were also obtained from this administrative database and from the 2011 national census. The association between each socioeconomic indicator and age-standardized prevalence was measured using the difference in prevalence, population attributable risk, relative inequality index, and regression coefficient. The prevalence of type 2 diabetes and hypertension was 6.16% and 19.35%, respectively, and varied across parishes. These prevalences were significantly associated with low educational level, low tertiary sector weight, unemployment, and low-income rate (with prevalence differences between the most and least advantaged deciles up to 1.3% and 5.3%, respectively). Socioeconomic factors accounted for up to 20% of prevalence. This study design did not allow us to evaluate causality and it may underestimate these diseases prevalence or its association with socioeconomic factors, but its results are in line with the evidence from other countries. These results emphasize the socioeconomic and geographical patterning of major diseases associated with a high mortality, and the need of health policies targeting the most deprived parishes.

  18. Epicardial fat thickness: distribution and association with diabetes mellitus, hypertension and the metabolic syndrome in the ELSA-Brasil study.

    Science.gov (United States)

    Graeff, Daniela Bertol; Foppa, Murilo; Pires, Julio Cesar Gall; Vigo, Alvaro; Schmidt, Maria Ines; Lotufo, Paulo Andrade; Mill, Jose Geraldo; Duncan, Bruce Bartholow

    2016-04-01

    Epicardial fat thickness (EFT) has emerged as a marker of cardiometabolic risk, but its clinical use warrants proper knowledge of its distribution and associations in populations. We aimed to describe the distribution of EFT, its demographic correlates and independent associations with diabetes, hypertension and metabolic syndrome (MS) in free-living Brazilian adults. From the baseline echocardiography of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)-a cohort study of civil servants aged 35-74 years-EFT was measured from a randomly selected sample of 998 participants as the mean of two paraesternal windows obtained at end systole (EFTsyst) and end diastole (EFTdiast). From the 421 individuals free of diabetes, hypertension and MS, we defined EFT reference values and the EFTsyst 75th percentile cut-off. Median EFTsyst was 1.5 (IQR 0-2.6) mm; a large proportion (84 %) had EFTdiast = 0. EFT was higher in women and lower in blacks, and increased with age and BMI. Although EFT was higher in those with diabetes, hypertension, and MS, EFT associations were reduced when adjusted for age, sex and ethnicity, and were non-significant after adjusting for obesity measures. In conclusion, the amount of EFT in this large multiethnic population is smaller than reported in other populations. EFT reference values varied across demographic and clinical variables, EFT associations with cardiometabolic variables being largely explained by age, sex, ethnicity and central obesity. Although EFT can help identify individuals at increased cardiometabolic risk, it will likely have a limited additional role compared to current risk stratification strategies.

  19. Effect of type 2 diabetes mellitus on the pharmacokinetics and transplacental transfer of nifedipine in hypertensive pregnant women.

    Science.gov (United States)

    Filgueira, Gabriela Campos de Oliveira; Filgueira, Osmany Alberto Silva; Carvalho, Daniela Miarelli; Marques, Maria Paula; Moisés, Elaine Christine Dantas; Duarte, Geraldo; Lanchote, Vera Lucia; Cavalli, Ricardo Carvalho

    2017-07-01

    Diabetes mellitus can inhibit cytochrome P450 3A4, an enzyme responsible for the metabolism of nifedipine, used for the treatment of hypertension in pregnant women. We aimed to assess the effect of type 2 diabetes mellitus (T2DM) on the pharmacokinetics, placental transfer and distribution of nifedipine in amniotic fluid in hypertensive pregnant women. The study was conducted in 12 hypertensive pregnant women [control group (CG)] and 10 hypertensive pregnant women with T2DM taking slow-release nifedipine (20 mg, 12/12 h). On the 34th week of gestation, serial blood samples were collected (0-12 h) after administration of the medication. At delivery, samples of maternal and fetal blood and amniotic fluid were collected for determination of nifedipine distribution in these compartments. The median pharmacokinetic parameters of CG were: peak plasma concentration (Cmax ) 26.41 ng ml(-1) , time to reach Cmax (tmax ) 1.79 h, area under the plasma concentration vs. time curve from 0-12 h (AUC0-12 ) 235.99 ng.h ml(-1) , half-life (t½) 4.34 h, volume of distribution divided by bioavailability (Vd/F) 560.96 l, and ClT /F 84.77 l h(-1) . The parameters for T2DM group were: Cmax 23.52 ng ml(-1) , tmax 1.48 h, AUC0-12 202.23 ng.h ml(-1) , t½ 5.00 h, Vd/F 609.40 l, and apparent total clearance (ClT /F) 98.94 l h(-1) . The ratios of plasma concentrations of nifedipine in the umbilical vein, intervillous space and amniotic fluid to those in the maternal vein for CG and T2DM were 0.53 and 0.44, 0.78 and 0.87, respectively, with an amniotic fluid/maternal plasma ratio of 0.05 for both groups. The ratios of plasma concentrations in the umbilical artery to those in the umbilical vein were 0.82 for CG and 0.88 for T2DM. There was no influence of T2DM on the pharmacokinetics or placental transfer of nifedipine in hypertensive women with controlled diabetes. © 2017 The British Pharmacological Society.

  20. Preparedness of Tanzanian health facilities for outpatient primary care of hypertension and diabetes: a cross-sectional survey.

    Science.gov (United States)

    Peck, Robert; Mghamba, Janneth; Vanobberghen, Fiona; Kavishe, Bazil; Rugarabamu, Vivian; Smeeth, Liam; Hayes, Richard; Grosskurth, Heiner; Kapiga, Saidi

    2014-05-01

    Historically, health facilities in sub-Saharan Africa have mainly managed acute, infectious diseases. Few data exist for the preparedness of African health facilities to handle the growing epidemic of chronic, noncommunicable diseases (NCDs). We assessed the burden of NCDs in health facilities in northwestern Tanzania and investigated the strengths of the health system and areas for improvement with regard to primary care man