[FULL TEXT]  [PDF]

Background: Diabetes Mellitus (DM) and its complications are a common problem among Yemeni population. Hypertension is commonly associated with type II DM. Both are risk factors for vascular complications. This study was designed to assess the prevalence of hypertension in Yemeni patients with Type II DM, and its association with macrovascular and microvascular complications. Objective: The aim of this study is to determine the prevalence of hypertension among Yemeni patients with diabetic Type II, and its association with vascular complications of DM. Subjects and methods: A Cross Sectional Study was carried out in Al-Thawra Hospital, between June to December 2007. A total of one hundred eighty-nine adult patients with Type II DM were included in the study. The diagnosis of Diabetes was based on the WHO criteria, while the diagnosis of hypertension was based on the criteria of the fifth Joint National Committee (JNC-5). The patients were divided into two groups: with and without hypertension, and their clinico-laboratory parameters were studied and analyzed. Results: The mean age was 55.6 ± 10.2 years, and mean BMI was 22.61 ± 3.6 kg/m ² . The mean time duration of DM was 8.9 ± 6.3 years. The prevalence of hypertension in Type II diabetic patients was 55% (N = 104 patients). No significant differences were observed in the duration, sex and BMI of both groups. Hypertension was significant in the elderly, low HDL cholesterol, and poor glycemic control group. The hypertensive diabetic groups were observed to have more ischemic heart disease (IHD), diabetic nephropathy, diabetic retinopathy and peripheral neuropathy than the normotensive diabetics. Conclusion: Hypertension is common among Yemeni patients with Type II DM. It's associated with increased prevalence of both micro-and macro-vascular complications.

[ABSTRACT]  [FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

Background: Autonomic dysfunction appears to play a significant role in the development of atrial fibrillation (AF), and impaired heart rate recovery (HRR) during exercise treadmill testing (ETT) is a known marker for autonomic dysfunction. However, whether impaired HRR is associated with incident AF is unknown. We studied the association of impaired HRR with the development of incident AF, after controlling for demographic and clinical confounders. Methods: We studied 8236 patients referred for ETT between 2001 and 2004, and without a prior history of AF. Patients were categorized by normal or impaired HRR on ETT. The primary outcome was the development of AF. Cox proportional hazards modeling was used to control for demographic and clinical characteristics. Secondary analyses exploring a continuous relationship between impaired HRR and AF, and exploring interactions between cardiac medication use, HRR, and AF were also conducted. Results: After adjustment, patients with impaired HRR were more likely to develop AF than patients with normal HRR (HR 1.43, 95% confidence interval (CI) 1.06, 1.93). In addition, there was a linear trend between impaired HRR and AF (HR 1.05 for each decreasing BPM in HRR, 95% CI 0.99, 1.11). No interactions between cardiac medications, HRR, and AF were noted. Conclusion: Patients with impaired HRR on ETT were more likely to develop new-onset AF, as compared to patients with normal HRR. These findings support the hypothesis that autonomic dysfunction mediates the development of AF, and suggest that interventions known to improve HRR, such as exercise training, may delay or prevent AF.

[ABSTRACT]  [FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]

[FULL TEXT]  [PDF]