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Cited by 339Cardiovascular Function and Risk FactorsDiabetes, Cardiovascular Risks, and LipoproteinsBlood Pressure and Hypertension Studies

Effect of Type 2 Diabetes Mellitus on Left Ventricular Geometry and Systolic Function in Hypertensive Subjects: Hypertension Genetic Epidemiology Network (HyperGEN) Study

Palmieri, Vittorio, Bella, Jonathan N., Arnett, Donna K., Liu, Jennifer E., Oberman, Albert, Schuck, Min-Yan, Kitzman, Dalane W., Hopkins, Paul N. +3 more·2001·Circulation
DOI 10.1161/01.cir.103.1.102
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Abstract

Background —Type 2 diabetes is a cardiovascular risk factor. It remains to be elucidated in a large, population-based sample whether diabetes is associated with changes in left ventricular (LV) structure and systolic function independent of obesity and systolic blood pressure (BP). Methods and Results —Among 1950 hypertensive participants in the HyperGEN Study without overt coronary heart disease or significant valve disease, 20% (n=386) had diabetes. Diabetics were more likely to be women, black, older, and have higher BMI and waist/hip ratio than were nondiabetics. After adjustment for age and sex, diabetics had higher systolic BP, pulse pressure, and heart rate; lower diastolic BP; and longer duration of hypertension than nondiabetics. LV mass and relative wall thickness were higher in diabetic than nondiabetic subjects independent of covariates. Compared with nondiabetic hypertensives, diabetics had lower stress-corrected midwall shortening, independent of covariates, without difference in LV EF. Insulin levels and insulin resistance were higher in non–insulin-treated diabetics (n=195) than nondiabetic (n=1439) subjects (both P <0.01). Insulin resistance positively but weakly related to LV mass and relative wall thickness. Conclusions —In a relatively healthy, population-based sample of hypertensive adults, type 2 diabetes was associated with higher LV mass, more concentric LV geometry, and lower myocardial function, independent of age, sex, body size, and arterial BP. structural and functional abnormalities in addition to, and independent of, atherosclerosis. 13 14 In the Framingham cohort, diabetes was associated with higher LV mass in women but not men. 15 High blood pressure (BP), obesity, and abnormal lipid profile, which often coexist with diabetes, tend to be associated with preclinical cardiovascular abnormalities 16 and may contribute to the association of diabetes with cardiovascular events. Cardiac features of diabetic and nondiabetic hypertensive subjects remain incompletely described in population-based samples. Therefore, we compared clinical and metabolic characteristics, LV geometry, and systolic function between diabetic and nondiabetic hypertensive participants in the Hypertension Genetic Epidemiology Network (HyperGEN) Study.

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  • In other populations, such as the STRONG heart study and Framingham heart study, diabetes or metabolic syndrome appear to be significant risk factors for LV hypertrophy.

    “In other populations, such as those in the STRONG heart study (native Americans of the western United States) and the Framingham heart study, diabetes or the metabolic syndrome do appear to be significant risk factors for LV hypertrophy (272, 306, 358).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [272]

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Authors
Palmieri, V., Bella, J. N., Arnett, D. K., Liu, J. E., Oberman, A., Schuck, M.-Y., Kitzman, D. W., Hopkins, P. N., Morgan, D., Rao, D. C., & Devereux, R. B.
Affiliations
University of Minnesota (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-01-02
Volume
103
Issue
1
Pages
102-107
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.103.1.102
OpenAlex
W2139884473
Cited by
339
References
50
Citations by year
2026: 2 · 2025: 6 · 2024: 11 · 2023: 8 · 2022: 8 · 2021: 5 · 2020: 15 · 2019: 17 · 2018: 11 · 2017: 14 · 2016: 11 · 2015: 10 · 2014: 16 · 2013: 14 · 2012: 16
FWCI
12.90
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (HL 54472, 5 R01 HL55673, 5 U10 HL54471, U10HL054471, R01HL055673)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
type 2 diabetes, hypertension, left ventricular geometry, left ventricular mass, relative wall thickness, left ventricular systolic function, left ventricular ejection fraction, insulin resistance, insulin levels, cardiovascular risk
MeSH terms
Adult, Blood Glucose, Blood Pressure, Body Constitution, Cholesterol, Diabetes Mellitus, Type 2, Female, Heart Function Tests, Heart Ventricles, Humans, Hypertension, Cholesterol, HDL, Male, Middle Aged, Organ Size, Systole, Triglycerides, Ultrasonography, Comorbidity, Body Mass Index, Ventricular Function, Left, Age Distribution, Sex Distribution, Ventricular Remodeling, Black People, White People

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