Nocturnal Hypertension Predictor of progression of Diastolic Dysfunction among Diabetes patients Without HF: Study

A study in Hypertension aimed to examine how patterns of nocturnal hypertension in individuals with diabetes and without heart failure affect left ventricular diastolic dysfunction. The researchers found that “during the absence of HF periods, nocturnal hypertension is an important predictor for the progression of LV diastolic dysfunction in diabetes patients.”

The study followed 154 diabetes and 268 nondiabetes subjects for 36.8±18.2 months without HF. It investigated the relationship between nocturnal hypertension patterns and LV diastolic dysfunction outcome, defined as an increase in E/e′>14, in patients with and without diabetes.

Key findings from the study are:

· The diabetes status and nocturnal hypertension patterns demonstrated a statistically significant interaction effect on the occurrence of E/e′>14 with a hazard rate.

· Based on Kaplan-Meier analysis results, patients with diabetes with non-dipper and riser had a greater risk for a diastolic dysfunction event.

· Based on results from multivariable Cox proportional hazards, non-dipper and riser patterns were associated with a greater risk of the outcome of LV diastolic dysfunction with a hazard ratio of 4.56 and 3.89, respectively.

· There no similar significant associations were found in patients without diabetes.

Concluding further, they said that during the absence of HF periods, nocturnal hypertension is a significant predictor for the progression of LV diastolic dysfunction in diabetic patients.

Study limitations include limited generalizability, the atrial volume not being evaluated, and E/eʹ’s inability to accurately reflect LV filling pressure in patients with preserved ejection fraction. Nocturnal hypertension assessment was only performed at enrollment.

Reference:

Kidawara Y, Kadoya M, Igeta M, et al. Nocturnal hypertension and left ventricular diastolic dysfunction in patients with diabetes with the absence of heart failure: prospective cohort HSCAA study. Hypertension. Published online November 22, 2023. doi:10.1161/HYPERTENSIONAHA.123.21304