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Impact of diabetes ...
Impact of diabetes mellitus on regression of electrocardiographic left ventricular hypertrophy and the prediction of outcome during antihypertensive therapy: the Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study
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Okin, P. M. (author)
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Devereux, R. B. (author)
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Gerdts, E. (author)
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show more...
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Snapinn, S. M. (author)
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Harris, K. E. (author)
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- Jern, Sverker, 1954 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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Kjeldsen, S. E. (author)
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Julius, S. (author)
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Edelman, J. M. (author)
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Lindholm, L. H. (author)
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- Dahlöf, Björn, 1953 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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show less...
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(creator_code:org_t)
- 2006
- 2006
- English.
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In: Circulation. - 1524-4539. ; 113:12, s. 1588-96
- Related links:
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https://gup.ub.gu.se...
Abstract
Subject headings
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- BACKGROUND: Diabetes mellitus is associated with increased cardiovascular (CV) morbidity and mortality and with greater ECG left ventricular hypertrophy (LVH); however, it is unclear whether diabetes attenuates regression of hypertensive LVH and whether regression of ECG LVH has similar prognostic value in diabetic and nondiabetic hypertensive individuals. METHODS AND RESULTS: A total of 9193 hypertensive patients (1195 with diabetes) in the Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study were treated with losartan- or atenolol-based regimens and followed up with serial ECG and blood pressure determinations at baseline and 6 months and then yearly until death or study end. ECG LVH was defined with gender-adjusted Cornell voltage-duration product (CP) criteria >2440 mm . ms. After a mean follow-up of 4.8+/-0.9 years, patients with diabetes had less regression of CP LVH (-138+/-866 versus -204+/-854 mm . ms, P<0.001), remained more likely to have LVH by CP (56.0% versus 48.1%, P<0.001), and had higher rates of CV death, myocardial infarction, stroke, and all-cause mortality and of the LIFE composite end point of CV death, myocardial infarction, or stroke. In multivariable Cox proportional hazards models, in-treatment regression or absence of ECG LVH by CP was associated with between 17% and 35% reductions in event rates in patients without diabetes but did not significantly predict outcome in patients with diabetes. CONCLUSIONS: Hypertensive patients with diabetes have less regression of CP LVH in response to antihypertensive therapy than patients without diabetes, and regression of ECG LVH is less useful as a surrogate marker of outcomes in hypertensive patients with diabetes. These findings may in part explain the higher CV morbidity and mortality in hypertensive patients with diabetes, and the absence of a demonstrable improvement in prognosis in diabetic patients in response to regression of ECG LVH suggests a more complex interrelation between underlying LV structural and functional abnormalities and outcome in these patients.
Keyword
- Aged
- Aged
- 80 and over
- Antihypertensive Agents/*pharmacology/therapeutic use
- Atenolol/pharmacology/therapeutic use
- Diabetes Complications/drug therapy/mortality/physiopathology
- Diabetes Mellitus/mortality/*physiopathology
- Double-Blind Method
- Electrocardiography
- Female
- Humans
- Hypertension/drug therapy/mortality
- Hypertrophy
- Left Ventricular/*drug therapy/mortality
- Losartan/pharmacology/therapeutic use
- Male
- Middle Aged
- Prognosis
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
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- By the author/editor
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Okin, P. M.
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Devereux, R. B.
-
Gerdts, E.
-
Snapinn, S. M.
-
Harris, K. E.
-
Jern, Sverker, 1 ...
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show more...
-
Kjeldsen, S. E.
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Julius, S.
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Edelman, J. M.
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Lindholm, L. H.
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Dahlöf, Björn, 1 ...
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show less...
- Articles in the publication
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Circulation
- By the university
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University of Gothenburg