Myocardial alterations in diabetes and hypertension

Stephen M. Factor, Alain Borczuk, Maureen J. Charron, Frederick S. Fein, Karen H. Van Hoeven, Edmund H. Sonnenblick

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Diabetes mellitus is a complex group of diseases that has hyperglycemia as a common metabolic abnormality. Although it is well-known that diabetic patients are susceptible to the effects of large vessel atherosclerosis with specific cardiac and cerebral complications, the association of diabetes mellitus with cardiac dysfunction caused by cardiomyopathy in the absence of significant coronary artery disease has been recognized for many years. However, the pathogenesis of diabetic cardiomyopathy remains unknown and has been somewhat controversial. Specifically, whether diabetes mellitus with its metabolic effects is sufficient to account for cardiomyopathy remains to be proven. This paper reviews the evidence for and against a metabolic etiology. In addition, we review the clinical and experimental evidence that supports the view that diabetes mellitus acts together with hypertension to produce structural damage in the heart that manifests as ventricular dysfunction and ultimately congestive heart failure. The concomitant effects of the metabolic derangements of diabetes and the vascular abnormalities associated with hypertension may lead to microvascular-induced tissue injury. Findings supporting this hypothesis are presented, along with observations suggesting that treatment with vasodilating calcium channel blockers or angiotensin converting enzyme inhibitors may be beneficial in regard to tissue pathology and mortality in experimental models. Recent clinical studies also support a role for the microcirculation in diabetics. Finally, it is suggested that if the microcirculation is pathogenetically involved in diabetic cardiomyopathy, then agents that improve microcirculatory flow along with tight control of hypertension may be as beneficial in the treatment or prevention of diabetic cardiomyopathy as strict metabolic control of hyperglycemia.

Original languageEnglish (US)
JournalDiabetes Research and Clinical Practice
Volume31
Issue numberSUPPL.
DOIs
StatePublished - Jul 1996

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Diabetic Cardiomyopathies
Diabetes Mellitus
Microcirculation
Hypertension
Cardiomyopathies
Hyperglycemia
Ventricular Dysfunction
Calcium Channel Blockers
Diabetes Complications
Angiotensin-Converting Enzyme Inhibitors
Blood Vessels
Coronary Artery Disease
Atherosclerosis
Theoretical Models
Heart Failure
Pathology
Mortality
Wounds and Injuries
Therapeutics

Keywords

  • Cardiomyopathy
  • Diabetes mellitus
  • Hypertension
  • Microcirculation

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Factor, S. M., Borczuk, A., Charron, M. J., Fein, F. S., Van Hoeven, K. H., & Sonnenblick, E. H. (1996). Myocardial alterations in diabetes and hypertension. Diabetes Research and Clinical Practice, 31(SUPPL.). https://doi.org/10.1016/0168-8227(96)01241-7

Myocardial alterations in diabetes and hypertension. / Factor, Stephen M.; Borczuk, Alain; Charron, Maureen J.; Fein, Frederick S.; Van Hoeven, Karen H.; Sonnenblick, Edmund H.

In: Diabetes Research and Clinical Practice, Vol. 31, No. SUPPL., 07.1996.

Research output: Contribution to journalArticle

Factor, SM, Borczuk, A, Charron, MJ, Fein, FS, Van Hoeven, KH & Sonnenblick, EH 1996, 'Myocardial alterations in diabetes and hypertension', Diabetes Research and Clinical Practice, vol. 31, no. SUPPL.. https://doi.org/10.1016/0168-8227(96)01241-7
Factor, Stephen M. ; Borczuk, Alain ; Charron, Maureen J. ; Fein, Frederick S. ; Van Hoeven, Karen H. ; Sonnenblick, Edmund H. / Myocardial alterations in diabetes and hypertension. In: Diabetes Research and Clinical Practice. 1996 ; Vol. 31, No. SUPPL.
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