Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have recently shown that mental stress increases local net release of tissue-type plasminogen activator (t-PA) across the forearm vascular bed. However, the mechanisms responsible for the t-PA release in man during stress are undefined. To study the effects of endothelial cell receptor stimulation and fluid shear stress we used the perfused forearm model to characterize the in vivo tissue plasminogen activator (t-PA) response in man to methacholine (Mch) and sodium nitroprusside (SNP), at doses calculated to cause similar degrees of vasodilation. The study was performed in 7 healthy young men (age 22-24 yrs) without hypertension, diabetes mellitus, or hypercholesterolemia. Each subject received double-blind step-wise i. a. infusions of Mch (0.1-0.8-4.0 micrograms/min) and SNP (0.5-2.5-10 micrograms/min) in randomized order. Each dose step was infused for 5 min. Forearm blood flow was assessed by plethysmography. Net release/uptake was expressed as the product of arterio-venous concentration gradient and forearm plasma flow. At pre-infusion baseline, there was a significant net release of t-PA antigen of approximately 0.9 ng x min-1 x 100 ml-1 and t-PA activity of 3.5 fmol x min-1 x 100 ml-1 across the forearm. I.a. infusion of Mch and SNP increased forearm blood flow from 1.9 to 14.9 and from 1.8 to 12.1 ml x min-1 x 100 ml-1, respectively (Mch vs SBP N.S.).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Release of tissue-type plasminogen activator in response to muscarinic receptor stimulation in human forearm. 787 38

To investigate whether the hyperinsulinemia observed in essential hypertensive subjects anticipates the onset of hypertension, and if it may play a role in predisposing to hypertension, we examined the relationships between fasting insulinemia (F.IRI), C-peptide (C-pep), and some known predictive factors of essential hypertension (EH), such as prehypertensive blood pressure, erythrocyte sodium concentration (ESC) and family history of hypertension. Sixty-two normotensive, lean, euglycemic subjects with no family history of diabetes were subdivided in 2 groups: 32 subjects without (F-) and 30 with (F+) family history of EH (at least one parent). The groups were matched for age, sex and body mass index. Systolic (SBP) and diastolic (DBP) blood pressures (p < 0.01 and p < 0.025, respectively), F.IRI (p < 0.0005), C-pep (p < 0.005), and ESC (p < 0.025) were significantly higher, and glucose/insulin ratio (p < 0.0005) lower in F+ than in F-. SBP (r = 0.43, p < 0.001) and DBP (r = 0.415, p < 0.001) were directly correlated to F.IRI and C-pep (respectively r = 0.418, p < 0.001 and r = 0.368, p < 0.01). A direct correlation was also found between mean blood pressure and ESC (r = 0.297, p < 0.05) and between ESC and F.IRI (r = 0.320, p < 0.05). In a separate analysis on the 2 subgroups F+ and F-, the above mentioned parameters were still correlated in the group with but not in the group without family history of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Insulinemia and intraerythrocytic sodium in normotensive normal-weight subjects with and without a family history for essential arterial hypertension]. 808 13

To investigate the relationship between cardiovascular autonomic neuropathy and nephropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM), 45 patients underwent noninvasive cardiovascular reflex tests, including the Valsalva ratio, the 30:15 ratio and postural changes in systolic blood pressure (delta SBP), along with measurement of creatinine clearance (CCr) and daily protein excretion (DPE). Clinical symptoms in 30 patients were also noted and correlated with the results of the autonomic function tests. Thirty-four normal subjects underwent the same cardiovascular reflex tests and served as controls. The results showed that NIDDM patients had a significantly lower 30:15 ratio than normal subjects. However, no significant difference in either the Valsalva ratio or delta SBP was found between diabetic patients and controls. A positive correlation between the 30:15 ratio and CCr, but not DPE, was noted in diabetics. Although abnormal cardiovascular reflex tests appeared in patients who had no autonomic symptoms, abnormal test results were not parallel with the severity of symptoms. These results show that NIDDM patients have poorer cardiovascular autonomic function which may precede the appearance of autonomic symptoms. The 30:15 ratio was weakly correlated with CCr and this suggests that the incidence of cardiovascular dysfunction increases as the renal functional reserve decreases.
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PMID:Cardiovascular autonomic dysfunction in non-insulin-dependent diabetes mellitus and its relation to renal dysfunction. 810 36

Coronary heart disease (CHD) is still relatively uncommon in the black population of South Africa. We embarked on a study to determine the prevalence of risk factors leading to CHD in the black population of Durban. The study sample was selected from patients attending a dental clinic at a hospital. A total of 458 Zulus (age range 16-69 years) were studied. The prevalence of CHD was 2.4%. The prevalence percentage of selected risk factors were: hypertension (SBP > or = 140 mmHg and/or a DBP > or = 90 mmHg) was 28%, males 31.9%, females 25.4%; protective levels of high density lipoprotein cholesterol/total cholesterol (HDLC/TC) (> or = 20%) were 81.3%; diabetes, males 4.9%, females 2.9%; smoking > or = ten cigarettes per day, males 28.1%, females 3.4%; obesity, males 3.7%, females 22.6%. We have found the Minnesota Coding System for ECG changes of CHD and Rose questionnaire to be unreliable for eliciting CHD in Blacks. Hypercholesterolaemia is less common and this may explain the low incidence of CHD in Blacks. Epidemics of CHD as seen in the Indian, 'mixed' and white South Africans can still be prevented in the black population but preventive measures must be instituted rapidly.
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PMID:Study of risk factors leading to coronary heart disease in urban Zulus. 811 40

This investigation was performed to determine whether diabetes mellitus has an additive effect on diminishing coronary perfusion reserve index in hypertensive patients. Coronary perfusion reserve index, thallium lung uptake, the electrocardiogram and haemodynamic parameters were evaluated by exercise thallium myocardial perfusion scintigraphy. In 18% of hypertensive and 13% of diabetic-hypertensive patients there was evidence of left ventricular hypertrophy on electrocardiogram. The maximum heart rate achieved in hypertensive, diabetic and diabetic-hypertensive patients was significantly lower (P < 0.05) than in control patients. The maximum SBP achieved in hypertensive (210 +/- 40 mmHg) and diabetic-hypertensive patients (216 +/- 36 mmHg) was higher (P < 0.05) than in control patients (186 +/- 32 mmHg). A significantly higher number of diabetic patients (53%) did not achieve the exercise rate pressure product of > 26,000 when compared with control (27%), hypertensive (24%) and diabetic-hypertensive (30%) patients. Coronary perfusion reserve index in hypertensive patients decreased significantly (P < 0.05) when compared with control (no hypertension, no diabetes) patients (1.67 +/- .14 vs. 1.79 +/- .17). Coronary vasodilatory reserve index was also reduced significantly (P < 0.05) in diabetic patients in comparison with controls (1.66 +/- .17 vs. 1.79 +/- .17), and was further reduced in diabetic-hypertensive patients when compared with control patients (1.63 +/- .13 vs. 1.79 +/- .17). Thallium uptake in the lung quantified as thallium lung to heart ratio were comparable in all four groups. The results suggest that diabetes mellitus diminishes the coronary perfusion reserve index in patients with hypertension and therefore many account for the increased cardiovascular morbidity in these patients.
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PMID:Alteration of coronary perfusion reserve in hypertensive patients with diabetes. 815 7

The aim of this study was to evaluate the action of trandolapril on blood glucose control and microalbuminuria in mild to moderate hypertensive in patients with non-insulin-dependent diabetes. Sixty-seven patients, aged between 33 and 79, were enrolled. After a two week placebo run-in period, treatment with trandolapril as monotherapy was given for 3 months. The dose of trandolapril was adjusted between 1 and 4 mg/day according to antihypertensive response. Patients were assessed clinically and by laboratory investigations each month. Two patients were excluded from efficacy analysis because of major protocol deviations. Mean DBP fell, under the influence of treatment, from 101 +/- 5 mmHg to 82 +/- 7 mmHg (p < 0.0001) and mean SBP from 171 +/- 9 mmHg tp 147 +/- 11 mmHG (p < 0.0001). At three months, 54 patients (84%) had a DBP < or = 90 mmHg. Microalbuminuria decreased significantly (p = 0.03) during treatment. Microalbuminuria returned to normal in 11 of the 13 patients in whom the baseline value was above 21 micrograms/min and increased to above normal in 2 of the 26 patients who had a normal baseline value. Blood glycosylated hemoglobin, fructosamine, glucose and creatinine, and creatinine clearance remained stable. Plasma potassium rose slightly in 7 patients. Six adverse events were reported (4 coughs, 1 peripheral edema, 1 plantar mal perforans). One patient died from pulmonary embolism. In conclusion, trandolapril is an effective antihypertensive agent in hypertensive diabetics. Trandolapril causes a significant decrease in microalbuminuria and does not interfere with blood glucose control in these patients.
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PMID:[Action of trandolapril on the blood glucose balance and microalbuminuria in hypertensive diabetics]. 817 83

Beat-to-beat heart rate (HR) and blood pressure (BP) were measured by the Finapres system in 28 healthy subjects and 64 diabetic subjects. Autonomic controls in diabetic subjects were assessed by scoring 5 cardiovascular function tests (high score = abnormal control). The fractal dimension (FD) of HR (or SBP) was estimated as follows: Measuring the curve of 500 successive HRs with a rule of length L, one obtains N times L. The FD is the slope of the regression line of Log(N) versus Log(1/L) for different L. We found a lower FD of HR in diabetic subjects than in healthy subjects (1.35 +/- 0.10/1.44 +/- 0.09, p = 0.0002) and a similar FD of SBP in the 2 groups. In diabetic subjects, the FD of HR was negatively correlated with age (r = -0.27, p = 0.03), duration of diabetes (r = -0.33, p = 0.0078) and score of disautonomy (r = -0.43, p = 0.0007). So, heartbeat is more fractal in healthy status: a low fractal fluctuation is a sign of pathology.
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PMID:Fractal dimension of heart rate and blood pressure in healthy subjects and in diabetic subjects. 818 Jul 21

Cardiovascular disease is one of the most important public health problems in developed countries. We have studied the epidemiology of the following cardiovascular disease risk factors in a random sample (n = 704) of the adult population of Catalonia (Spain): hypercholesterolemia (> or = 6.1) mmol/l or 240 mg/dl), hypertension (SBP > or = 160 and/or DBP > or = 95 mmHg), low HDL-cholesterol concentrations (< 0.9 mmol/l or 35 mg/dl), hypertriglyceridemia (> 2.8 mmol/l or 250 mg/dl), obesity (BMI > 30), smoking and history of diabetes and coronary heart disease. Two percent of participants had hypertriglyceridemia, 3% had a history of coronary heart disease, 4% a history of diabetes, 6% low HDL-cholesterol concentrations, 12% were obese, 20% had hypertension, 24% had hypercholesterolemia and 36% were smokers. 58% of hypertensive individuals had been previously detected, 46% were currently on treatment, and 21% had their blood pressure controlled (SBP < 160 and DBP < 95 mmHg). Correlation and multiple regression analyses were used to investigate the association between cardiovascular risk factors. Multiple linear regression analysis showed independent correlations between risk factors. Prevalence of hypercholesterolemia, obesity and diabetes was higher and prevalence of smoking was lower in hypertensives than normotensives. The odds ratio was 3.68 (95% CI = 2.07-6.54) for hypercholesterolemia, 3.26 (95% CI = 1.52-7.02) for obesity, 3.81 (95% CI = 1.09-7.02) for diabetes and 0.40 (95% CI = 0.22-0.70) for smoking. The adjusted odds ratio was statistically significant for hypercholesterolemia (OR = 2.74, 95% CI = 1.01-3.75). The prevalence of cardiovascular risk factors was similar to that observed in other Mediterranean communities.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiology of cardiovascular disease risk factors in Catalonia (Spain). 824 92

In order to investigate the blood pressure-heart rate interrelation and their circadian pattern in type I diabetes mellitus, we performed ambulatory blood pressure monitoring in 28 normotensive patients without clinical nephropathy divided in two groups. Group A consisted of 14 males with short-term DM (mean 2 years, mean age 28 +/- 6 years), group B consisted of 14 males with long-term DM (mean 12 years, mean age 31 +/- 7 years). Ambulatory blood pressure monitoring revealed significantly higher night heart rate in B group (74 +/- 13 l/min vs. 62 +/- 11 l/min in A, p < 0.01) and day diastolic blood pressure (83 +/- 9 mm Hg vs. 74 +/- 8 mm Hg in A, p < 0.01) and night diastolic blood pressure (73 +/- 10 mm Hg vs. 62 +/- 8 mm Hg in A, p < 0.01). The linear regression SBP/HR equation were significantly different (p < 0.02) (HR = 0.48 x SBP + 21, r = 0.40 in A vs. HR = 0.29 x SBP + 69, r = 0.28 in B). We concluded that type I diabetes duration has significant influence on diastolic blood pressure and heart rate even in patients without diabetic nephropathy and could be related to changed sensitivity of the baroreceptors.
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PMID:[Circadian rhythm of blood pressure and pulse rate in young men with diabetes mellitus type I depending on duration of disease]. 836 72

Although hypertension and diabetes mellitus frequently appear as comorbidities, the pharmacotherapy of hypertension in patients with diabetes mellitus can aggravate underlying carbohydrate and lipid abnormalities. To evaluate the efficacy and safety of the long-acting angiotensin converting enzyme inhibitor ramipril in patients with insulin-dependent or non-insulin-dependent diabetes mellitus, the authors conducted a double-blind, placebo-controlled study. After a single-blind washout period, 58 patients were randomly assigned to receive 2.5 mg of ramipril or a 2.5-mg placebo, each once daily. Each patient underwent titration and maintenance phases for a total treatment period of 12 weeks. By the end of maintenance, 54% of patients maintained the target blood pressure 24 hours after receiving ramipril compared with 19% in the placebo group (P = 0.008). Between baseline and the end of maintenance, ramipril decreased mean supine systolic/diastolic blood pressure (SBP/DBP) measured 24 hours after the last dose by 9/8 mmHg (P < or = 0.001/P < or = 0.001); placebo decreased SBP/DBP by 2/4 mmHg (NS/P < or = 0.05). Between-group differences were significant (P < 0.05). During this time, blood glucose, hemoglobin Alc, lipoproteins, and biochemistry were unchanged in the ramipril group. There were no between-group differences in the number or types of adverse events. In our study of patients with diabetes mellitus, once-daily ramipril controlled blood pressure, was well tolerated, and had no effects on carbohydrate or lipid metabolism.
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PMID:Double-blind, placebo-controlled study of ramipril in diabetics with mild to moderate hypertension. 845 57


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