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      Non-Dipping Heart Rate, Microalbuminuria and Thrombocytosis in Type 2 Diabetes Mellitus: Can We Connect the Dots?

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          Influence of heart rate on mortality among persons with hypertension: the Framingham Study.

          Previous studies have shown positive associations between heart rate and both all-cause and cardiovascular mortality. These relationships, however, have not been investigated in persons with hypertension. Using 36-year follow-up data from the Framingham Study, we evaluated from 4530 subjects, aged 35 to 74, whose blood pressures were > or = 140 mm Hg systolic or > or = 90 mm Hg diastolic and who were not treated with antihypertensive medication. We used pooled logistic regression to calculate biennial mortality rates. Odds ratios and 95% confidence intervals for each increment in heart rate of 40 beats/min, adjusted for age and systolic blood pressure level, were: for all-cause mortality, 2.18 (1.68, 2.83) for men and 2.14 (1.59, 2.88) for women; and for cardiovascular mortality, 1.68 (1.19, 2.37) for men and 1.70 (1.08, 2.67) for women. Exclusion of outcomes in the first 2 or 4 years after measurement of heart rate did not materially change the results, which suggests that rapid heart is not merely an indicator of preexisting illness. Therefore heart rate may be an independent risk factor for cardiovascular death in persons with hypertension.
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            Mean Platelet Volume in Type 2 Diabetes Mellitus

            Context: diabetes mellitus is a global pandemic. The increased platelet activity may play a role in the development of vascular complications of this metabolic disorder. The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Larger platelets are younger and exhibit more activity. Aims: to determine the MPV in diabetics compared to nondiabetics, to see if there is a difference in MPV between diabetics with and without vascular complications, and to determine the correlation of MPV with fasting blood glucose, glycosylated hemoglobin (HbA1c), body-mass index, and duration of diabetes in the diabetic patients. Materials and Methods: platelet counts and MPV were measured in 300 Type 2 diabetic patients and 300 nondiabetic subjects using an automated blood cell counter. The blood glucose levels and HbA1c levels were also measured. Statistical evaluation was performed by SPSS using Student's t test and Pearson correlation tests. Results: the mean platelet counts and MPV were higher in diabetics compared to the nondiabetic subjects [277.46 ± 81 X 109/l vs. 269.79 ± 78 X 109/l (P= 0.256)], 8.29 ± 0.74 fl versus 7.47 ± 0.73 fl (P= 0.001), respectively. MPV showed a strong positive correlation with fasting blood glucose, postprandial glucose and HbA1C levels (P=0.001). Conclusions: our results showed significantly higher MPV in diabetic patients than in the nondiabetic subjects. This indicates that elevated MPV could be either the cause for or due to the effect of the vascular complications. Hence, platelets may play a role and MPV can be used as a simple parameter to assess the vascular events in diabetes.
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              Blunted Heart Rate Dip During Sleep and All-Cause Mortality

              Although it has been somewhat overlooked, resting heart rate is an established predictor of cardiovascular and noncardiovascular outcome. We assessed the determinants and mortality associations of heart rate measured during ambulatory blood pressure monitoring (ABPM) to evaluate its informativeness during activity and sleep.
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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2014
                August 2014
                25 June 2014
                : 129
                : 1
                : 25-27
                Affiliations
                Memorial Hermann Hospital and Heart and Vascular Institute, Houston, Tex., USA
                Author notes
                *Bharat K. Kantharia, MD, FRCP, FAHA, FACC, FESC, FHRS, 5616 Jackson Street, Unit 2315, Houston, TX 77030 (USA), E-Mail bkantharia@yahoo.com
                Article
                363283 Cardiology 2014;129:25-27
                10.1159/000363283
                24969020
                16851f3c-447d-4ae6-aa31-7e59b1c996d4
                © 2014 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 28 April 2014
                : 28 April 2014
                Page count
                Pages: 3
                Categories
                Editorial Comment

                General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Heart rate,Diabetes mellitus,Heart rate variability,Atherosclerosis,Ambulatory blood pressure monitoring,Blood pressure,Autonomic nervous system,Pathophysiology,Cardiovascular risk factors

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