High blood pressure, diabetes cut heart's reserve

By Will Boggs, MD

NEW YORK (Reuters Health) - The reserve capacity of the heart is impaired in people with diabetes and with high blood pressure, even when they don't have actual coronary artery disease, and this could ultimately lead to heart failure, according to a new report.

"Strict control of both hypertension and diabetes is essential to avoid the development of clinical syndromes," Dr. Miguel Quintana from the Karolinska Institute, Stockholm, Sweden told Reuters Health.

Quintana and colleagues used an ultrasound technique to study the heart while it was being forced to beat strongly by infusion of a stimulating drug in 128 patients without coronary artery disease.

Several features differed significantly between healthy subjects and patients with high blood pressure with or without diabetes, the team reports in the American Journal of Hypertension.

Basically, the researchers found that the heart's main pumping chamber, the left ventricle, had less in reserve among subjects with hypertension and in those with diabetes, and the coexistence of both conditions appeared to have an additive detrimental effect.

In a related editorial, Dr. Paul Poirier from Hopital Laval, Sainte-Foy, Quebec, Canada says the study provides more evidence that diabetes itself can cause heart failure. "The challenge from a clinical point of view is to screen these patients to prevent long-term cardiac complications in this high risk population."

SOURCE: American Journal of Hypertension, August 2006.