This study aimed to evaluate the effects of glycated hemoglobin (HbA ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN-controlled diabetes mellitus and RHTN-uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA <7.0% (RHTN-controlled diabetes mellitus: n = 98) and HbA ≥7.0% (RHTN-uncontrolled diabetes mellitus: n = 122). Intima-media thickness and flow-mediated dilation were measured by high-resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid-femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN-uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN-uncontrolled diabetes mellitus. Intima-media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA was an independent predictor of flow-mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function.
Human, dog, and cat fleas, as well as bedbugs, feed by biting their victims,
causing acute prurigo, which is aggravated in sensitized victims (papular
urticaria). The lesions appear in the classic "breakfast, lunch, and dinner"
pattern. There are two main explanations: the parasites "map" the skin area in
search of the best places to bite, and their removal when victim scratches, and
then reattach to the skin. Treatments aim to control pruritus, as well as
hypersensitivity reactions when necessary. Prevention is based on environmental
control measures. The "breakfast, lunch, and dinner" sign is a definitive marker
for diagnosis and the parasite´s identification and control.
the valsartan/amlodipine group compared with the amlodipine/atenolol group. 16 Telmisartan, 17 candesartan, 18 eprosartan, and other angiotensin II type 1 receptor blockers were studied and showed similar results.
Laurent and coworkers
CONFLICT OF INTERESTThe authors do not have any conflicts of interest to disclose.
ORCID
Juan C. Yugar-Toledo
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.