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 ◽  
...  

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.

2018 ◽  
Vol 20 (7) ◽  
pp. 1740-1750 ◽  
Author(s):  
Marie‐Eve Piché ◽  
Anne‐Sophie Laberge ◽  
Patrice Brassard ◽  
Benoit J. Arsenault ◽  
Olivier F. Bertrand ◽  
...  

2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.


2015 ◽  
Vol 18 (16) ◽  
pp. 3013-3019 ◽  
Author(s):  
Huashan Bi ◽  
Yong Gan ◽  
Chen Yang ◽  
Yawen Chen ◽  
Xinyue Tong ◽  
...  

AbstractObjectiveBreakfast skipping has been reported to be associated with type 2 diabetes (T2D), but the results are inconsistent. No meta-analyses have applied quantitative techniques to compute summary risk estimates. The present study aimed to conduct a meta-analysis of observational studies summarizing the evidence on the association between breakfast skipping and the risk of T2D.DesignSystematic review and meta-analysis.SettingRelevant studies were identified by a search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and SINOMED up to 9 August 2014. We also reviewed reference lists from retrieved articles. We included studies that reported risk estimates (including relative risks, odds ratios and hazard ratios) with 95 % confidence intervals for the association between breakfast skipping and the risk of T2D.SubjectsEight studies involving 106 935 participants and 7419 patients with T2D were included in the meta-analysis.ResultsA pooled adjusted relative risk for the association between exposure to breakfast skipping and T2D risk was 1·21 (95 % CI 1·12, 1·31; P=0·984; I2=0·0 %) in cohort studies and the pooled OR was 1·15 (95 % CI, 1·05, 1·24; P=0·770; I2=0·0 %) in cross-sectional studies. Visual inspection of a funnel plot and Begg’s test indicated no evidence of publication bias.ConclusionsBreakfast skipping is associated with a significantly increased risk of T2D. Regular breakfast consumption is potentially important for the prevention of T2D.


2019 ◽  
Vol 126 (2) ◽  
pp. 444-453 ◽  
Author(s):  
Silvana Roberto ◽  
Raffaele Milia ◽  
Azzurra Doneddu ◽  
Virginia Pinna ◽  
Girolamo Palazzolo ◽  
...  

Metaboreflex is a reflex triggered during exercise or postexercise muscle ischemia (PEMI) by metaboreceptor stimulation. Typical features of metaboreflex are increased cardiac output (CO) and blood pressure. Patients suffering from metabolic syndrome display hemodynamic abnormalities, with an exaggerated systemic vascular resistance (SVR) and reduced CO response during PEMI-induced metaboreflex. Whether patients with type 2 diabetes mellitus (DM2) have similar hemodynamic abnormalities is unknown. Here we contrast the hemodynamic response to PEMI in 14 patients suffering from DM2 (age 62.7 ± 8.3 yr) and in 15 age-matched controls (CTLs). All participants underwent a control exercise recovery reference test and a PEMI test to obtain the metaboreflex response. Central hemodynamics were evaluated by unbiased operator-independent impedance cardiography. Although the blood pressure response to PEMI was not significantly different between the groups, we found that the SVR and CO responses were reversed in patients with DM2 as compared with the CTLs (SVR: 392.5 ± 549.6 and −14.8 ± 258.9 dyn·s−1·cm−5; CO: −0.25 ± 0.63 and 0.46 ± 0.50 l/m, respectively, in DM2 and in CTL groups, respectively; P < 0.05 for both). Of note, stroke volume (SV) increased during PEMI in the CTL group only. Failure to increase SV and CO was the consequence of reduced venous return, impaired cardiac performance, and augmented afterload in patients with DM2. We conclude that patients with DM2 have an exaggerated vasoconstriction in response to metaboreflex activation not accompanied by a concomitant increase in heart performance. Therefore, in these patients, blood pressure response to the metaboreflex relies more on SVR increases rather than on increases in SV and CO. NEW & NOTEWORTHY The main new finding of the present investigation is that subjects with type 2 diabetes mellitus have an exaggerated vasoconstriction in response to metaboreflex activation. In these patients, blood pressure response to the metaboreflex relies more on systemic vascular resistance than on cardiac output increments.


BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101636 ◽  
Author(s):  
Bjørn Gjelsvik ◽  
Anh Thi Tran ◽  
Tore J Berg ◽  
Åsne Bakke ◽  
Ibrahimu Mdala ◽  
...  

BackgroundCoronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.AimTo describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & settingA cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.MethodSummary statistics with adjustments and binary logistic regression models were used.ResultsIn total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).ConclusionThe diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.


2018 ◽  
Vol 3 (2) ◽  
pp. 186
Author(s):  
Rusdiati Helmidanora ◽  
Triswanto Sentat

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.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Curtis Tilves ◽  
Allison Kuipers ◽  
Joseph Zmuda ◽  
J. J Carr ◽  
James G Terry ◽  
...  

Background: CT-derived muscle density (MD) reflects the degree of adiposity in muscle (i.e., myosteatosis) with lower MD indicating greater adiposity. Previous research indicates lower MD is associated with increased risk of type 2 diabetes (T2D). However, few studies have compared the association of simultaneously measured MD by anatomic location. The relationship between myosteatosis and cardiometabolic health may differ by body site and influence which location(s) is most useful for risk assessment. We investigated potential differential relationships between T2D and MD of the locomotor muscles of the abdomen (psoas), thigh, and calf among 539 African Caribbean men from Tobago. Methods: Men were aged 50-91 years (mean 64.4 years, mean BMI 27.5 kg/m 2 ). Calf MD was measured at 66% of calf length using peripheral quantitative CT; calf MD was defined as the ratio of muscle mass to cross-sectional muscle area. Psoas MD was measured in the abdomen (between L3/L4) and thigh MD was measured in the mid-thigh using CT; for these, MD was defined as the average muscle attenuation across each site. MDs were converted to per-SD units for comparability. T2D was defined as a fasting serum glucose level of ≥126 mg/dL or currently taking antidiabetic medication. Results: Psoas and thigh MDs were more highly correlated (r = 0.70) than psoas and calf (r = 0.33) or thigh and calf (r = 0.53) MDs, and calf MD was moderately correlated with BMI (r = -0.38) compared to lower BMI correlations for thigh (r = -0.18) or psoas (r = -0.16) MDs (all significant p < 0.05). After age and lifestyle factor adjustment (Table), a 1-SD lower MD of the thigh or calf was significantly associated with higher odds of T2D. Additional adjustment for BMI completely attenuated the association with T2D for thigh MD, but not calf MD. Conclusion: In our study of African Ancestry men, only calf MD was associated with higher odds of T2D independent of BMI and other muscle groups. Longitudinal studies are needed to better characterize specific muscle myosteatosis and metabolic abnormalities.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Michelangela Barbieri ◽  
Maria Rosaria Rizzo ◽  
Ilaria Fava ◽  
Celestino Sardu ◽  
Nicola Angelico ◽  
...  

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.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sudong Liu ◽  
Jing Liu ◽  
Ruiqiang Weng ◽  
Xiaodong Gu ◽  
Zhixiong Zhong

Abstract Background The role of apolipoprotein E gene (APOE) in lipid metabolism has been well established, and APOE is associated with the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). However, the relationship between APOE polymorphisms and type 2 diabetes (T2DM) with or without CVD remains unclear. Methods In this cross-sectional study, a total of 924 participants including 211 controls (CVD-T2DM-), 247 T2DM patients with CVD (CVD-T2DM+), 232 CVD patients without T2DM (CVD + T2DM-) and 234 T2DM patients with CVD (CVD + T2DM+), were genotyped using chip platform. The association between APOE polymorphisms and T2DM patients with or without CVD was analyzed by univariable and multivariable logistic analysis. Results The present study showed that the frequency of E3/E4 increased in T2DM patients with CVD (p < 0.01). The ε4 allele was higher in CVD patients without T2DM (p < 0.01) and T2DM patients with CVD (p < 0.01) as compared with the controls. Conclusions The subjects carrying ε4 allele have increased risk of CVD and T2DM, and exhibit higher level of lipid profiles.


Sign in / Sign up

Export Citation Format

Share Document