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QJM Advance Access originally published online on November 4, 2005
QJM 2005 98(12):879-884; doi:10.1093/qjmed/hci137
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© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Left ventricular hypertrophy in normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment

A. Sato, L. Tarnow, F.S. Nielsen, E. Knudsen and H.-H. Parving1

From the Steno Diabetes Center, Gentofte and 1Faculty of Health Science, University of Aarhus, Aarhus, Denmark

Address correspondence to Dr L. Tarnow, Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark. email: ltar{at}steno.dk

Received 7 June 2005 and in revised form 5 October 2005

Background: Left ventricular hypertrophy (LVH) is an independent risk factor for myocardial ischaemia, cardiac arrhythmia, sudden death, and heart failure, all common findings in patients with type 2 diabetes.

Aim: To determine the prevalence of, and risk factors for, LVH in normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment.

Design: Cross-sectional study.

Methods: From 1994 to 1998, M-mode echocardiography was performed by one experienced examiner in 262 consecutive, normoalbuminuric Caucasian type 2 diabetic patients, all with blood pressure <160/95 mmHg and not taking antihypertensive medication. Mean ± SD age was 54 ± 10 years, 109 were women, and median known duration of diabetes was 4 (range 1–28) years. Body mass index (BMI) was 28 ± 5 kg/m2, and blood pressure 134 ± 13/79 ± 8 mmHg, all means ± SD. Median urinary albumin excretion rate was 9 (range 2–30) mg/24 h.

Results: The prevalence of LVH indexed to height2.7 was 43% (95%CI 38–50%), and was similar in men and women. BMI, HbA1c and log urinary albumin excretion were significantly associated with left ventricular hypertrophy in a logistic regression model, whereas sex, age, known duration of diabetes and blood pressure were not. Similar results were obtained for left ventricular mass index.

Discussion: LVH was frequent in our normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment. Several potentially modifiable risk factors, such as raised BMI, poor glycaemic control and elevated urinary albumin excretion rate, were associated with LVH.


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