Prevalence of Masked Hypertenstion in Type 2 Diabetic...

The main finding of this study is that the serum ADMA levels were significantly increased in MHT patients with DM compared to normotensive diabetic subjects. ADMA levels, BMI, and low HDL levels were independent predictors of MHT in patients with DM. ADMA levels positively correlated with ABPM measurements, especially daytime measurements, but were not related to office BP measurements. ADMA levels may play a role in prediction, with a good sensitivity and negative predictive value but poor specificity and positive predictive value. To the best of our knowledge, this is the first study to examine the relationship between ADMA and MHT in the current literature. Ng et al. studied in a total of 133 DM patients, 18% of whom had MHT. It was†¦show more content†¦In another elegant human trial, Achan et al. demonstrated that ADMA infusion increases systemic vascular resistance by 24%, and mean arterial BP by 6% in healthy subjects and that a bolus dose of ADMA decreases cardiac output by 15% [18]. In a second part of that study, it was shown that a handgrip maneuver increased cardiac output in control subjects by 96%, but in subjects given ADMA, cardiac output increased by only 35%. ADMA concentration 30 min after the infusion was 2.6 mol/L, however, the baseline value was not provided. In addition, several studies have shown that serum ADMA levels are increased in essential hypertension about two fold and are related to impaired endothelial function [5,16]. Perticone and colleagues found that ADMA in essential hypertensive subjects was strongly and inversely associated with the peak increase in forearm blood flow [5]. These studies demonstrated that ADMA plays an important role in the regulation of vascular tone. It is known that ADMA levels are increased among type 2 DM patients [19]. On the contrary, in a small study, Paiva et al. reported decreased ADMA level in diabetics due to renal hyperfiltration [20]. It seems that the prognostic value of ADMA is more important in patients with DM [21]. Krzyzanowska et al. reported that ADMA predicted cardiovascular events and enhanced the predictive role of CRP in patients with type 2 diabetes. In