Coronary artery disease, microalbuminuria and lipid profile in patients with non-insulin dependent diabetes mellitus.

PURPOSE: To determine the frequency of coronary artery disease, microalbuminuria and the relation to lipid profile disorders, blood pressure and clinical and metabolic features. METHODS: Fifty-five type 2 diabetic patients (32 females, 23 males), aged 59.9 +/- 9 years and with known diabetes duration of 11 +/- 7.3 years were studied. Coronary artery disease (CAD) was defined as a positive history of myocardial infarction, typical angina, myocardial revascularization or a positive stress testing. Microalbuminuria was defined when two out of three overnight urine samples had a urinary albumin excretion ranging 20-200 micrograms/min. RESULTS: CAD was present in 24 patients (43.6%). High blood pressure (HBP) present in 32 patients (58.2%) and was more frequent in CAD group (p = 0.05) HBP. Increased the risk of CAD 3.7 times (CI[1.14-12]). Microalbuminuria was present in 25 patients (45.5%) and tended to associate with higher systolic blood pressure (SBP) (p = 0.06), presence of hypertension (p = 0.06) and known diabetes duration (p = 0.08). In the stepwise multiple logistic regression the systolic blood pressure was the only variable that influenced UAE (r = 0.39, r2 = 0.14, p = 0.01). The hypertensive patients had higher cholesterol levels (p = 0.04). CONCLUSION: In our sample the frequency of microalbuminuria, hypertension, hypercholesterolemia and CHD was high. Since diabetes is an independent risk factor for cardiovascular disease, the association of others risk factors suggest the need for an intensive therapeutic intervention in primary and in secundary prevention.

[Significance and prognosis of ventricular extrasystole induced by exertion in patients with arterial hypertension with a normal electrocardiogram]. / Significado e prognóstico das extra-sístoles ventriculares induzidas pelo esforço em portadores de hipertensão arterial com electrocardiograma normal.

We studied 13 patients with systemic arterial hypertension and normal electrocardiograms so as to evaluate the significance and prognosis of frequent and complex ventricular premature beats (VPB) induced by exercise testing. After a period of 9 to 33 months of follow-up (mean = 17.6 months), we repeated the exercise testing with the same protocol in all cases. In nine patients (69.2%), the arrhythmia disappeared during exercise, two increased the number of VPB and two others reduced the number of the arrhythmia. Complications, such as sustained ventricular tachycardia, were not seen in any case. The appearance of frequent and complex VPB with stress testing does not seem enhance the risk of sudden death or episodes of spontaneous ventricular tachycardia in patients with arterial hypertension but without electrocardiographic signs of cardiac hypertrophy.