Diabetic and Hypertensive Heart Disease

  title={Diabetic and Hypertensive Heart Disease},
  author={Ehud Grossman and Franz Messerli},
  journal={Annals of Internal Medicine},
Diabetes mellitus and hypertensiontwo disorders that frequently coexist in the same patientlead to structural and functional cardiac impairments that accelerate progression to cardiovascular illness and death from cardiovascular causes [1, 2]. Clinical and experimental studies suggest that the presence of diabetes and hypertension in the same patient results in more severe cardiomyopathy than would be expected with either condition alone [3, 4]. We summarize the features of heart disease in… 

Hypertension and diabetes.

Aggressive control of blood pressure, cholesterol and glucose levels should be attempted to reduce the cardiovascular risk of diabetic hypertensive patients.

Current Controlled Trials in Cardiovascular Medicine

Careful attention to the criteria described for the cardiovascular dysmetabolic syndrome should help identify those at risk of subsequent disease at an early stage of diabetes mellitus.

Clinical significance of cardiovascular dysmetabolic syndrome

  • P. Deedwania
  • Medicine, Biology
    Current controlled trials in cardiovascular medicine
  • 2002
Careful attention to the criteria described for the cardiovascular dysmetabolic syndrome should help identify those at risk of subsequent disease at an early stage of diabetes mellitus.

High blood pressure and diabetes mellitus: are all antihypertensive drugs created equal?

Intensive control of blood pressure reduced cardiovascular morbidity and mortality in diabetic patients regardless of whether low-dose diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, or calcium antagonists were used as a first-line treatment.

Heart Failure in Diabetic Patients

The epidemiologic evidence implicating diabetes as a risk factor for heart failure, the abnormalities in left ventricular function observed in patients with diabetes, and the cellular and molecular abnormalities that may be of importance in the development of heart failure are examined.

Diabetic cardiomyopathy: evidence, mechanisms, and therapeutic implications.

Evidence is presented that diabetes is associated with a cardiomyopathy, independent of comorbid conditions, and that metabolic disturbances, myocardial fibrosis, small vessel disease, cardiac autonomic neuropathy, and insulin resistance may all contribute to the development of diabetic heart disease.

Myocardial dysfunction and cardiovascular disease in type 2 diabetes

  • A. Ofstad
  • Medicine, Biology
    Scandinavian journal of clinical and laboratory investigation
  • 2016
A multi-factorial approach (i.e. targeting several CV risk factors simultaneously) is superior to a strict glucose lowering strategy in reducing risk for macrovascular events, and recent research may even support an effect also on HF outcomes.

Comparison of Clinical Outcomes Following Acute Myocardial Infarctions in Hypertensive Patients With or Without Diabetes

In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.

Heart Failure and Cardiac Dysfunction in Diabetes

The Framingham Heart Study demonstrated that patients with diabetes have an increased incidence of heart failure, which contributes significantly to their high cardiovascular morbidity and mortality, and the impact of diabetes was even more striking.



Myocardial disease in hypertensive-diabetic patients.

Hypertensive-diabetic cardiomyopathy in the rat: an experimental model of human disease.

The similarity of the lesions with those observed in human patients suggests that the hypertensive-diabetic rat is a useful model for elucidating the pathogenesis of clinical myocardial disease in patients with hypertension and diabetes mellitus.

Clinical and morphological features of human hypertensive-diabetic cardiomyopathy.

Diabetic Cardiomyopathy

  • F. Fein
  • Medicine, Biology
    Diabetes Care
  • 1990
Clinical studies are needed to clarify the natural history of this disorder, focusing on the benefits of tight control of hyperglycemia and treatment of associated hypertension, and Experimental studies will clarify the pathophysiology and contribute to improved therapy.

Evidence for cardiomyopathy in familial diabetes mellitus.

A diffuse extravascular abnormality may be a basis for cardiomyopathic features in diabetes, and postmortem studies performed in uncomplicated diabetics suggest a myopathic process without ischemia.


Cardiac implications of hypertension and diabetes

New imaging techniques have significantly contributed to the clinical identification and characterization of the disease, and even newer techniques—including scintigraphy and ultrasound—will further help to clarify this common cardiac problem.

A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease.

The hearts obtained at autopsy of 67 patients with hypertension, diabetes mellitus, or both were examined microscopically and histochemically, and the amount of fibrosis was determined. Significant

Left ventricular mass in diabetes-hypertension.

The data suggest that DM accelerates the development of LVH in patients with essential hypertension independent of arterial pressure and, therefore, may contribute to the increased cardiovascular morbidity and mortality in Patients with hypertension.