The role of early hemodynamic impairment and disease duration on diabetic cardiomyopathy and hypertension in central Africans with atherosclerosis.

Diabetes mellitus (DM) is strongly associated with cardiomyopathy and hypertension. This study focuses on early hemodynamic impairment and DM exposure time amplified by atherosclerosis before the onset of associated cardiomyopathy and hypertension in central Africans. Prospectively, demographic, hemodynamic, lipid, anthropometric, and urinary data of 48 atheromatous diabetics, 39 uncomplicated diabetics, and 27 normal subjects before incidence of cardiomyopathy, hypertension, stroke, and peripheral vascular disease (PVD) were analysed. Age, waist-hip ratio (WHR), DM duration, blood pressures (BPs), pulse pressure (PP), mean arterial pressure (MAP), lipidic profile, and microalbuminuria were more elevated in atheromatous diabetics than in uncomplicated diabetes and normal subjects. PP, MAP, BP of atheromatous diabetics were significantly (P<.01) correlated with age, DM duration, and microalbuminuria, but stroke volume was negatively (P<.001) correlated with diastolic blood pressure (DBP) and microalbuminuria. The evolution of atheromatous diabetes was characterized by the onset of the highest rates of hypertension (86.2%), cardiomyopathy and congestive failure (69%), stroke (46%), and PVD (42%). Atheromatous diabetes of central Africans is associated with early and age-induced significant changes of PP, BP, the highest rates of hypertension, cardiomyopathy, stroke, and PVD. Impaired left ventricular function, as stroke volume decreases with increasing DBP, C-peptide, and microalbuminuria, precedes cardiomyopathy and congestive failure in African diabetics.