e294 Journal of Hypertension

Vol 28, e-Supplement A, June 2010

Design and Method: 386 patients with TDM1 aged from 5 to 18 years old
from three different regions of Russian Federation were examined in the
course of screening programs. Average duration of TDM1 was 2,81 year. The
level of HbA1 and microalbuminuria (MAU) were measured on Bayer DCA
2000 analyzer. The ophthalmoscopy was performed by direct view method.
The technique of blood pressure (BP) measurement was standardized.
Statistical analysis was performed with -square criteria and Mann-Whitney
test.
Results: Children and adolescents with T1DM had BP level more higher
than the same rate in healthy children for equal aging group. 21 % of children
with T1DM had a systolic blood pressure (SBP) on 95 % for aging standard
(p 0,004). Diastolic blood pressure (DBP) levels were not significantly
different. During ophthalmoscopy the retinopathy was diagnosed in 12% of
patients, 1,1 % of adolescents had proliferative retinopathy at the duration of
T1DM more than 5 years. MAU was not indicated as neither children nor
adolescents. Median of HbA1 level in adolescents was on 1,6% in excess of
prepubertal children (9,8% vs 8,25%, p < 0,001), that indicate on pure
metabolic control in group of adolescents and high risk of microangiopathies
development.
Conclusions: SBP in diabetes children is an effective marker of early
development of retinopathy. Retinopathy and high SBP were combined
more frequently in adolescents with poor metabolic control.
PP.17.146

INTRARENAL BLOOD FLOW DOPPLER SPECTRA IN

DIABETIC PATIENTS AND HYPERTENSIVE DIABETIC
PATIENTS

O. Koshelskaya, R. Karpov. Institute of Cardiology, Tomsk, Russia

Objectives: The aim of the study was to determine the changes of Doppler
spectra indices of intrarenal blood flow in diabetic patients with/without
hypertension; to compare the changes of intrarenal vascular resistance in
hypertensive diabetic patients with/without microalbuminuria.
Methods: The 28 diabetic patients (Gr.D), 52 hypertensive patients (Gr.H),
208 diabetic hypertensive patients (Gr.HD) and 14 healthy people (control
group). were included. The were no differences between the hypertensive
groups in sex, age, BP-24 h levels and duration of arterial hypertension. Renal
blood flow velocities profiles were detected by duplex scanning index in
renal and arcuate intrarenal arteries; on the grounds of which resistive index
in the segmental (RIs) and arcuate intrarenal arteries (RIar) was calculated.
24-hour ambulatory BP recordings were performed. Serum insulin concentration were measured by radioimmune method. 24-hour urinary protein
excretion was determined by standart laboratory method.
Results: 34,1% diabetic hypertensive patients, 13,3% hypertensive patients
(P 0,0005 vs Gr.HD) and 7,7% diabetic patients (P 0,0245 vs Gr.HD)
have microalbuminuria. Even normotensive diabetic patients show an
increase in intrarenal vascular resistance: RIar levels were 0,63
0,05 and
0,59
0,04 in Gr.D vs 0,54
0,06 and 0,48
0,02 in the control group,
respectively. Compared with pts of Gr.H, in pts of Gr.HD was observed
more marked increase in intrarenal vascular resistance: RIar levels were
0,60
0,05 in Gr.HD vs 0,57
0,06 in Gr.H. In pts with microalbuminuria,
the elevated indices of intrarenal vascular resistance were positively associated with duration of hypertension, age, levels of HbA1, triglycerides, total
cholesterol and negatively associated with decrease in diastolic BP-day,
diastolic BP-24 h and duration of diastolic arterial hypertension during
daytime at disproportional increase in systolic BP.
Conclusions: Our results show that the increase in intrarenal resistance is
developed at earlier stages of diabetes. Hypertensive diabetic patients
developed the increase in intrarenal resistance and/or microalbuminuria
earlier as compared to hypertensive patients without diabetes.
PP.17.147

tion. The prevalence of asymptomatic DHF was estimated in 27% in the

general population. Left ventricular diastolic dysfunction (LVDD) has been
described as an early preclinical manifestation of a specific cardiomyopathy
in patients with DM without hypertension and known coronary artery
disease.
The aim of this study was to determine the prevalence of LVDD in a
normotensive population with well-controlled DM type 2 and without signs
and symptoms of DHF.
Design-Methods: 114 outpatients with DM type 2, 48(42.1%) male and
66(57.9%) female with mean age of 44
8.2 years, were enrolled in this
study. All patients were normotensive with well-controlled diabetes
(HbA1c<6.5), without evidence of heart failure, coronary artery disease,
thyroid or overt renal disease and with normal electrocardiogram and
thoracic x-ray. All patients underwent Doppler echocardiography by a
single experience cardiologist with use the Valsalva maneuver on analysis
of mitral flow. The diagnosis of LVDD has been according to the criteria of
Heart Failure and Echocardiography Associations of the European Society
of Cardiology.
Results: A total of 62(63.2%) patients, 23 male (49.7% of men) and 39 female
(59.1% of women) had LVDD. 48(77.4%) patients had impaired relaxation
pattern of LVDD, 14(22.6%) had pseudonormal pattern and no one had
restrictive pattern of LVDD. Female gender and duration of diabetes had
positive correlation with the presence of LVDD. Parameters of metabolic
syndrome had no correlation with LVDD. The presence of LVDD increased
according to increasing age.
Conclusion: In our study, the prevalence of LVDD in normotensive,
asymptomatic and well-controlled patients with DM type 2 is high. Mild
LVDD may be the first stage of diabetic cardiomyopathy. Patients with DM
type 2 maybe must screening for sub clinical LVDD by echocardiography.
PP.17.148

USEFULNESS OF 75G GLUCOSE TOLERANCE TEST

FOR DETECTION OF IMPAIRED GLUCOSE
TOLERANCE IN HYPERTENSIVE PATIENTS

H. Takase1, Y. Dohi2, T. Toriyama1, T. Okado1, H. Sonoda1, A. Hagikura1,

G. Kimura2. 1Enshu Hospital - Department of Internal Medicine, Hamamatsu,
Japan, 2Nagoya City University Graduate School of Medical Sciences - Department
of Cardio-Renal Medicine and Hypertension, Nagoya, Japan
Objective: Diagnosis of impaired glucose tolerance (IGT) is important in
patients with hypertension, because IGT often coexists with hypertension
and markedly increases cardiovascular risk in hypertensive individuals. The
present study was designed to investigate usefulness of glucose tolerance
test (GTT), as compared to fasting plasma glucose (FPG) levels, in the
evaluation of glucose metabolism in hypertensive patients.
Design and Method: We enrolled consecutive 7,012 participants in our
physical check-up program without anti-diabetic medications (1,957 hypertension; 5,055 normotension). First, glucose metabolism was assessed using
FPG. Second, among participants who had normal FPG levels, 333 participants were randomly selected and underwent 75 g GTT.
Results: The results are shown in the Table. The prevalence of IGT or
diabetes mellitus (DM) was about double in participants with hypertension
as compared to normotensive participants. Strikingly, about 30% and 20% of
hypertensive and normotensive participants, respectively, with normal FPG
showed disorder of glucose metabolism in GTT.

LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN

DIABETES MELLITUS TYPE 2

T. Exiara1, A. Konstantis1, L. Papazoglou2, M. Kouroupi3, A. Kalpaka4,

L. Mporgi5, A. Risggits5, E. Filippidou3, S. Terzi5, S. Papanastasiou1.
1
General Hospital Sismanoglio-Department of Internal Medicine, Komotini, Greece,
2
Military Hospital of Alexandroupolis-Department of Internal Medicine, Alexandroupolis, Greece, 3University Hospital Democritus University of Thrace-Department of Internal Medicine, Alexandroupolis, Greece, 4General Hospital Agios
Pavlos-Department of Internal Medicine, Thessaloniki, Greece, 5General Hospital
Sismanoglio-Department of Cardiology, Komotini, Greece
Objectives: Diabetes mellitus (DM) is a major risk factor for the development of heart failure. Diastolic heart failure (DHF) is a clinical syndrome
characterized by a preserved systolic function and abnormal diastolic func-

Conclusions: GTT is a useful and sensitive method to identify IGT or DM,

while FPG may not be adequate for this purpose. GTT should be used for
accurate detection of IGT or DM, especially in high risk population such as
hypertension.