Cardiorenal relationships in hypertensive patients with type 2 diabetes
THE AIM: to study the characteristics of cardiorenal relationships in hypertensive patients with diabetes mellitus (DM) type 2. PATIENTS AND METHODS. The study included 120 patients with arterial hypertension stage I-III in age from 40 to 65 years: 60 diabetic hypertensivepatients (studygroup) and 60 non-diabetichypertensive patients (control group). We performed ambulatory blood pressure monitoring, echocardiography, studied endothelial function, evaluated the artery stiffness, estimated renal function and metabolic parameters. RESULTS. A prognostic unfavorable changes of ambulatory blood pressure profile, a significantly higher incidence of left ventricular hypertrophy (LVH) were found in diabetic hypertensive patients in comparison with non-diabetic hypertensive patients. There were no patients with normal diastolic left ventricular function in the study group. Increased pulse wave velocity (PWV e.) was noted in 83.3 % diabetic hypertensive patients. More severe endothelial dysfunction, tubular and glomerular dysfunction were identified in diabetic hypertensive patients in comparison with non-diabetic hypertensive patients. Severe insulin resistance (IR) leaded to metabolic changes - glucosetoxicity, lipidotoxicity in diabetic hypertensive patients. CONCLUSION. The study shows the presence of cardiorenal interactions and interrelations between IR and target organ damage in hypertensive patients with type 2 diabetes. IR can be considered as an independent predictor cardiovascular and renal disease. Accordingly, IR correction will help us to optimize the results of treatment cardiovascular diseases and kidneys diseases in hypertensive patients with type 2 diabetes.