The optimal cut-off of blood pressure related to left ventricular diastolic dysfunction and remodeling in Asian diabetic patients.

BACKGROUND: Although a recent randomized trial found no difference between intensive and standard blood pressure (BP) control in patients with diabetes mellitus (DM), the debate over the optimal BP target continues. Thus, the present study investigated the effect of BP on the subclinical left ventricular (LV) function and structural changes in diabetic patients.

METHOD: A total of 2649 patients with DM who received echocardiography were enrolled in this study. Study population was stratified by three groups according to BP and presence of hypertension (normal, <130/80mmHg; prehypertension, ≥130/80mmHg without hypertension; hypertension, ≥140/90mmHg or history of hypertension). The odds ratios (ORs) of impaired LV diastolic function and LV remodeling were analyzed using multivariate logistic regression analysis. The adjusted mean values of echocardiographic parameters related to LV diastolic function and remodeling were also evaluated.

RESULT: When normal group was set as reference, the adjusted ORs [95% confidential interval (CI)] for impaired LV diastolic function was 2.45 (95% CI 1.84-3.24) in prehypertension, 3.51 (95% CI 2.57-4.80) in hypertension group. Adjusted ORs for LV remodeling only showed significant result in hypertension group [1.82 (95% CI 1.23-2.69)]. The adjusted mean value of LV diastolic function and structure also demonstrated LV deterioration in prehypertension and hypertension groups.

CONCLUSION: Our study showed the adverse influence of prehypertension and hypertension on subclinical LV deterioration. This finding suggested the potential clinical benefits of intensive BP control (<130/80mmHg) in patients with DM.