医学
心脏病学
内科学
糖尿病
危险系数
舒张期
铲斗
心力衰竭
比例危险模型
前瞻性队列研究
舒张性心力衰竭
血压
动态血压
内分泌学
置信区间
作者
Yonekazu Kidawara,Masumi Kadoya,Masataka Igeta,Akira Morimoto,Akio Miyoshi,Miki Kakutani‐Hatayama,Akinori Kanzaki,Kenzô Konishi,Yoshiki Kusunoki,Takashi Daimon,Masanori Asakura,Masaharu Ishihara,Hideki Koyama
出处
期刊:Hypertension
[Ovid Technologies (Wolters Kluwer)]
日期:2024-01-01
卷期号:81 (1): 172-182
标识
DOI:10.1161/hypertensionaha.123.21304
摘要
BACKGROUND: Diabetes is an important risk factor for heart failure (HF) and is associated with left ventricular (LV) diastolic dysfunction. However, diabetic comorbid conditions, such as nocturnal hypertension, as predictors of diastolic dysfunction are not known in the absence of an HF period. The present study was conducted as the longitudinal examination of the predictive value of nocturnal hypertension profiles on the progression of LV diastolic dysfunction in patients with and without diabetes without HF. METHODS: The subjects (154 diabetes and 268 nondiabetes) in the absence of HF were followed for 36.8±18.2 months. The relationships among the patterns of nocturnal hypertension and the outcome of LV diastolic dysfunction, defined as an increase in E/e′>14, were investigated in the patients with and without diabetes. RESULTS: The interaction effect of the diabetes status and the patterns of nocturnal hypertension on the hazard rate of the occurrence of E/e′>14 was statistically significant ( P =0.017). Kaplan-Meier analysis results revealed that patients with diabetes with nondipper ( P =0.021 versus dipper) and riser ( P =0.006 versus dipper) had a greater risk for a diastolic dysfunction event. Furthermore, multivariable Cox proportional hazards analysis revealed that nondipper (hazard ratio, 4.56 [95% CI, 1.49–13.96]; P =0.007) and riser (hazard ratio, 3.89 [95% CI, 1.31–11.57]; P =0.014) patterns were associated with elevated risk of the outcome of LV diastolic dysfunction. In contrast, no similar significant associations were found in patients without diabetes. CONCLUSIONS: During the absence of HF periods, nocturnal hypertension is an important predictor for the progression of LV diastolic dysfunction in patients with diabetes.
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