EFEK HIPOTENSIF DARI ACEi DAN ARB PADA PASIEN DIABETES MELLITUS DAN HIPERTENSI DI RSUD. ABDUL WAHAB SYAHRANIE SAMARINDA

2018 ◽  
Vol 3 (2) ◽  
pp. 186
Author(s):  
Rusdiati Helmidanora ◽  
Triswanto Sentat
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Secondary Data ◽  
National Committee ◽  
Blood Pressure Target ◽  
Blood Pressure Targets ◽  
Increased Risk ◽  
New Guidelines ◽  
National Joint Committee

More than two-thirds of patients with type 2 diabetes also experience hypertension whose development coincides with hyperglycemia, where each disease has a tendency to influence the increased risk of other diseases. Sundry new guidelines, such as the National Joint Committee 8, the American Diabetes Association recommend blood pressure targets in the diabetic population of <140/90 mmHg to reduce cardiovascular risk and prevent the progression of nephropathy. This study aims to determine whether there is a difference in achieving blood pressure target < 140/90 mmHg according to Join National Committee 8 between ACEi and ARB in patients with type 2 diabetes with hypertension. This research was conducted using a retrospective at internist clinic of Abdul Wahab Syahranie hospital, by taking secondary data from the medical record from blood pressure o 49 outpatients received a single antihypertensive either drug ACEi 29 people or ARB 34 people. This study showed that the achievement of target blood pressure by <140/90 mmHg (JNC 8 guideline) between ACEi 7 (28%) and ARB 5 (20,8%) group and it can be concluded that between ACEi and ARB drugs(P=0.5) there was no differsignificantly in achievement blood pressure target on type 2 diabetes with hypertension.

The Blood Pressure Response to Exercise in Youth with Impaired Glucose Tolerance and Type 2 Diabetes

2015 ◽  
Vol 27 (1) ◽  
pp. 120-127 ◽  
Author(s):  
Jane E. Yardley ◽  
Jacqueline Hay ◽  
Freya MacMillan ◽  
Kristy Wittmeier ◽  
Brandy Wicklow ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Pressure Response ◽  
Healthy Weight ◽  
Cross Sectional ◽  
Increased Risk ◽  
Graded Exercise ◽  
Consumption Rates ◽  
Response To Exercise

Type 2 diabetes is associated with hypertension and an increased risk of cardiovascular disease. In adults, blood pressure (BP) responses to exercise are predictive of these complications. To determine if the hemodynamic response to exercise is exaggerated in youth with dysglycemia (DG) compared with normoglycemic overweight/obese (OB) and healthy weight (HW) controls a cross-sectional comparison of BP and heart rate (HR) responses to graded exercise to exhaustion in participants was performed. DG and OB youth were matched for age, BMI z-score, height and sex. Systolic (SBP) and diastolic BP (DBP) were measured every 2 min, and HR was measured every 1 min. SBP was higher in OB and DG compared with HW youth at rest (p > .001). Despite working at lower relative workloads compared with HW, the BP response was elevated during exercise in OB and DG. For similar HR and oxygen consumption rates, BP responses to exercise were slightly higher in OB and DG compared with HW. OB and DG youth both display elevated resting and exercise BP relative to HW peers. Obesity may play a greater role than dysglycemia in the exaggerated BP response to exercise in youth.

scholarly journals Awaking Blood Pressure Surge and Progression to Microalbuminuria in Type 2 Normotensive Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Michelangela Barbieri ◽  
Maria Rosaria Rizzo ◽  
Ilaria Fava ◽  
Celestino Sardu ◽  
Nicola Angelico ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cox Regression ◽  
Blood Pressure Monitoring ◽  
Adult Patients ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Pressure Surge

Background. We investigated the predictive value of morning blood pressure surge (MBPS) on the development of microalbuminuria in normotensive adults with a recent diagnosis of type 2 diabetes.Methods. Prospective assessments of 24-hour ambulatory blood pressure monitoring and urinary albumin excretion were performed in 377 adult patients. Multivariate-adjusted Cox regression models were used to assess hazard ratios (HRs) between baseline and changes over follow-up in MBPS and the risk of microalbuminuria. The MBPS was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP.Results. After a mean follow-up of 6.5 years, microalbuminuria developed in 102 patients. An increase in MBPB during follow-up was associated with an increased risk of microalbuminuria. Compared to individuals in the lowest tertile (−0.67±1.10 mmHg), the HR and 95% CI for microalbuminuria in those in the highest tertile of change (24.86±6.92 mmHg) during follow-up were 17.41 (95% CI 6.26–48.42);pfor trend <0.001. Mean SD MBPS significantly increased in those who developed microalbuminuria from a mean [SD] of 10.6[1.4]to 36.8[7.1],p<0.001.Conclusion. An increase in MBPS is associated with the risk of microalbuminuria in normotensive adult patients with type 2 diabetes.

scholarly journals Current status of achieving blood pressure target and its clinical correlates in Japanese type 2 diabetes (JDDM45)

2017 ◽  
Vol 9 (3) ◽  
pp. 594-601 ◽  
Author(s):  
Hiroki Yokoyama ◽  
Shin-ichi Araki ◽  
Koichi Kawai ◽  
Koichi Hirao ◽  
Yoshio Kurihara ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Current Status ◽  
Blood Pressure Target ◽  
Clinical Correlates

The ideal blood pressure target to prevent cardiovascular disease in type 2 diabetes: A neutral viewpoint

2014 ◽  
Vol 24 (6) ◽  
pp. 577-584 ◽  
Author(s):  
S. Frontoni ◽  
A. Solini ◽  
P. Fioretto ◽  
A. Natali ◽  
A. Zuccalà ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Blood Pressure Target ◽  
The Ideal

scholarly journals Association of serum creatinine levels and risk of type 2 diabetes mellitus in Korea: a case control study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Do Kyeong Song ◽  
Young Sun Hong ◽  
Yeon-Ah Sung ◽  
Hyejin Lee
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Type 2 Diabetes Mellitus ◽  
Serum Creatinine ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Increased Risk

Abstract Background Reduced skeletal muscle has been suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in skeletal muscle. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. Methods We analyzed a total of 264,832 nondiabetic adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2015 in the Korean National Health Insurance Service Cohort. Hazard ratios for T2DM were calculated. Results In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association. This association was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Conclusions Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women with serum creatinine below 1.1 mg/dl, although this result was not statistically significant.

scholarly journals Blood pressure variability and risk of heart failure in ACCORD and the VADT

2020 ◽  
Author(s):  
Daniel S. Nuyujukian ◽  
Juraj Koska ◽  
Gideon Bahn ◽  
Peter D. Reaven ◽  
Jin J. Zhou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Blood Pressure Variability ◽  
Treatment Strategies ◽  
Risk Factor Management ◽  
Increased Risk ◽  
Blood Pressure Treatment

Objective: Although blood pressure variability is increasingly appreciated as a risk factor for cardiovascular disease, its relationship with heart failure is less clear. We examined the relationship between blood pressure variability and risk of heart failure (HF) in two cohorts of type 2 diabetes participating in trials of glucose and/or other risk factor management. <p> </p> <p>Research Design and Methods: Data were drawn from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Veterans Affairs Diabetes Trial (VADT). Coefficient of variation (CV) and average real variability (ARV) were calculated for systolic (SBP) and diastolic blood pressure (DBP) along with maximum and cumulative mean SBP and DBP during both trials. </p> <p> </p> <p>Results: In ACCORD, CV and ARV of SBP and DBP were associated with increased risk of HF, even after adjusting for other risk factors and mean blood pressure (e.g., CV-SBP: HR=1.15, <i>p</i> = 0.01; CV-DBP: HR=1.18, <i>p</i> = 0.003). In the VADT, DBP variability was associated with increased risk of HF (ARV-DBP: HR=1.16, <i>p</i> = 0.001; CV-DBP: HR=1.09, <i>p</i> = 0.04). Further, in ACCORD, those with progressively lower baseline blood pressure demonstrated a stepwise increase in risk of HF with higher CV-SBP, ARV-SBP, and CV-DBP. Effects of blood pressure variability were related to dips, not elevations, in blood pressure.</p> <p> </p> <p>Conclusions: Blood pressure variability is associated with HF risk in individuals with type 2 diabetes, possibly a consequence of periods of ischemia during diastole. These results may have implications for optimizing blood pressure treatment strategies in those with type 2 diabetes.</p>

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