scholarly journals Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes

2019 ◽  
Vol 32 (8) ◽  
pp. 796-803 ◽  
Author(s):  
Georgios Ponirakis ◽  
Ioannis N Petropoulos ◽  
Uazman Alam ◽  
Maryam Ferdousi ◽  
Omar Asghar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Nerve Conduction ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Fiber Density ◽  
Converting Enzyme Inhibitors ◽  
Perception Threshold ◽  
Pressure Lowering

Abstract BACKGROUND Diabetic peripheral neuropathy (DPN) can lead to foot ulceration and amputation. There are currently no disease-modifying therapies for DPN. The aim of this study was to determine if hypertension contributes to DPN in patients with type 1 diabetes mellitus (T1DM). METHODS Subjects with T1DM (n = 70) and controls (n = 78) underwent a comprehensive assessment of DPN. RESULTS Hypertension was present in 40 of 70 T1DM subjects and 20 of 78 controls. Hypertension was associated with abnormal nerve conduction parameters (P = 0.03 to <0.001), increased vibration perception threshold (P = 0.01) and reduced corneal nerve fiber density and length (P = 0.02) in subjects with T1DM. However, after adjusting for confounding factors only tibial compound motor action potential and nerve conduction velocity were associated with hypertension (P = 0.03) and systolic blood pressure (P < 0.01 to <0.0001). Hypertension had no effect on neuropathy in subjects without diabetes. CONCLUSIONS This study shows that hypertension is associated with impaired nerve conduction in T1DM. It supports previous small trials showing that angiotensin-converting enzyme inhibitors improve nerve conduction and advocates the need for larger clinical trials with blood pressure lowering agents in DPN.

Dangers of Captopril Therapy in Newborns

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1076-1076
Author(s):  
VIVIAN REZNIK ◽  
WILLIAM GRISWOLD ◽  
STANLEY MENDOZA
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Angiotensin Converting Enzyme ◽  
Premature Infant ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Treatment Of Hypertension

Angiotensin-converting enzyme inhibitors are effective at lowering blood pressure in the neonate and the child. However, these drugs, when used for the treatment of hypertension in the premature infant, must be used with caution to avoid the complications that are well documented in the literature. All of the infants described in the article by Perlman and Volpe had extreme hypotension and oligunia. A group of nine infants with renal failure complicating captopril therapy were recently reported from the same institution.

scholarly journals Prediction Models of Albumin Renal Excretion in Type 2 Diabetes Mellitus Patients

2019 ◽  
Vol 70 (11) ◽  
pp. 3802-3807
Author(s):  
Amorin Remus Popa ◽  
Claudia Teodora Judea Pusta ◽  
Cosmin Mihai Vesa ◽  
Simona Bungau ◽  
Camelia Liana Buhas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Positive Correlation

Microalbuminuria is a cardiovascular risk factor in type 2 diabetes mellitus patients. It is very important to know which the predictor factors for albuminuria are, because these elements may be influenced by pharmacological measures. In our study we propose three models for the prediction of albumin glomerular excretion in a group of 446 type 2 diabetes mellitus patients: the clinical-biochemical model, the pharmacological model, and the integrative model that reunites the two models. In the clinical-biochemical model, albumin excretion was statistically significant influenced by HbA1c (positive correlation) and blood pressure (positive correlation). In the pharmacological model, albumin excretion was influenced by angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation). In the integrative model, the factors were HbA1c (positive correlation), diastolic blood pressure (positive correlation), angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation) and statins treatment (negative correlation). The prevalence of microalbuminuria was 16.14 %. Patients with microalbuminuria had statistically significant higher values of HbA1c, systolic blood pressure, diastolic blood pressure, triglycerides and lower values of HDL-cholesterol. A low glucose control was the most important risk factor for an increased albumin glomerular elimination. The importance of our study consists in the fact that all the elements that predict albuminuria can be influenced: HbA1c, blood pressure, therapy with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and statins.

Sign in / Sign up

Export Citation Format

Share Document