Glycemic status in non diabetic elderly hypertensives with heart failure with preserved ejection fraction

Introduction: Epidemiological evidence suggests in-creasing proportion of elderly people. Hypertension, which is worldwide spread and represents the leading cause of death and of heart failure with preserved ejec-tion fraction (HFpEF), occurs in one half/two thirds of them. HFpEF is an important cause of disability and hospitalization and, unfortunately, until now, despite multiple randomized controlled trials, no disease-spe-cific therapy exists to improve prognosis. The prevalen-ce of glycemic disturbances increases with age.

Objective: The aim of our study was to assess glycemic status in non diabetic elderly patients hospitalized with arterial hypertension and HFpEF in an Internal Medi-cine Department.

Methods: 168 consecutive elderly patients, 65-94 years old, with arterial hypertension and HFpEF with unknown diabetes were enrolled into the study. For each patient we recorded demographic and anthropo-metric data, blood pressure measurements, BMI, com-plete lipid profile, and cardiovascular complications (ischemic heart disease, MI, stroke, angina pectoris). Glycemic status was defined by standard oral gluco-se tolerance test in all non diabetic patients. Patients were divided into 4 groups: 1) normal glucose tolerance (n=31), 2) impaired fasting glucose (IFG) (n=60), impaired glucose tolerance (IGT) (n=32), 4) newly diagnosed diabetes mellitus (n=45).

Results: Glucose intolerance was observed in 81.54% (n=137) elderly with HFpEF previously non diabetic hypertensive patients. 35.71% of them had impaired fasting glucose, 19.05% had impaired glucose toleran-ce, and 26.78% had newly diagnosed diabetes mellitus. Newly diagnosed diabetes mellitus in elderly patients with hypertension, HFpEF, and cardiovascular compli-cations was observed in 35%. In patients without cardi-ovascular complication only 14.7% had newly diagno-sed diabetes mellitus. The difference was statistically significant (p<0,001). There were no statistically signi-ficant differences between groups with/without cardio-vascular complications in impaired fasting glucose and impaired glucose tolerance.

Conclusions: Elderly hypertensive patients with HFpEF without previously diabetes mellitus had a high prevalence of glucose intolerance, with newly diagno-sed diabetes mellitus affecting more than a fourth of them. Frequency of newly diagnosed diabetes mellitus was twice high in elderly hypertensive with cardiovas-cular complications than in those with uncomplicated arterial hypertension. Special attention should be given to this group of patients.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)