Prevalence, impact and management of hypertension-mediated organ damage in type 2 diabetes patients.

OBJECTIVE: To determine the prevalence, impact and management of hypertension-mediated organ damage (HMOD) according to the presence of type 2 diabetes (T2DM). METHODS: IBERICAN is an ongoing multicenter, observational and prospective study, including outpatients aged 18-85 years who attended the Primary Care setting in Spain. In this study, the prevalence, impact and management of HMOD according to the presence of T2DM at baseline were analyzed. RESULTS: At baseline, 8066 patients (20.2% T2DM, 28.6% HMOD) were analyzed. Among patients with T2DM, 31.7% had hypertension, 29.8% dyslipidemia and 29.4% obesity and 49.3% had ≥1 HMOD, mainly high pulse pressure (29.6%), albuminuria (16.2%) and moderate renal impairment (13.6%). The presence of T2DM significantly increased the risk of having CV risk factors and HMOD. Among T2DM population, patients with HMOD had more dyslipidemia (78.2% vs 70.5%; P=0.001), hypertension (75.4% vs 66.4%; P=0.001), any CV disease (39.6% vs 16.1%; P=0.001) and received more drugs. Despite the majority of types of glucose-lowering agents were more frequently taken by those patients with HMOD, compared to the total T2DM population, the use of SGLT2 inhibitors and GLP-1 receptor agonists was marginal. CONCLUSIONS: In patients daily attended in primary care setting in Spain, one in five patients had T2DM and nearly half of these patients had HMOD. In patients with T2DM, the presence of HMOD was associated with a higher risk of CV risk factors and CV disease. Despite the very high CV risk, the use of glucose-lowering agents with proven CV benefit was markedly low.

Experimental infection of North American plethodontid salamanders with the fungus Batrachochytrium dendrobatidis.

The presence in the southeastern USA of Batrachochytrium dendrobatidis, a fungal pathogen of amphibians, is a potential threat to the diverse salamander assemblages in the region. In this study, we tested the susceptibility of plethodontid salamanders to infection with B. dendrobatidis. We experimentally infected one terrestrial species (Plethodon metcalfi) and one stream-dwelling species (Desmognathus monticola). Mortality of P. metcalfi due to B. dendrobatidis infection was 41.7% and was higher at 8 degrees C (75%) than at 16 degrees C (8.3%). B. dendrobatidis did not cause any mortality in D. monticola. Infected salamanders exhibited few of the clinical signs associated with B. dendrobatidis infection; however, they exhibited histologic signs of disease. Our results suggest that Plethodon species in the southeastern USA are at risk of becoming infected with B. dendrobatidis and developing chytridiomycosis. However, some animals may have survived with or cleared the infection. Additional studies are required to determine whether chytridiomycosis is a significant factor in declines of plethodontid salamanders.