Data from: Changes in left ventricular relaxation after azelnidipine treatment in hypertensive patients with diabetes: subanalysis of a prospective single-arm multicenter study

Objectives: We previously demonstrated that a calcium channel blocker,
azelnidipine, improves left ventricular relaxation in patients with
hypertension and diastolic dysfunction in a multicentre, Clinical impact
of Azelnidipine on Left VentricuLar diastolic function and OutComes in
patients with hypertension (CALVLOC) trial. The objectives of the present
subanalysis were to investigate the differences in diastolic function in
hypertensive patients with and without diabetes, and the efficacy of
azelnidipine on diastolic function among them. Design: Subanalysis of a
prospective single-arm multicentre study. Participants: 228 hypertensive
patients with normal ejection fraction and impaired left ventricular
relaxation (septal e′ velocity <8 cm/s on echocardiography)
enrolled for CALVLOC trial. They were divided into two groups based on
presence or absence of diabetes. Interventions: Administration of 16 mg of
azelnidipine for 8 months (range 6–10 months). Main outcome measures:
Septal e′ velocity before and at the end of the study. Results: Whereas
patients with diabetes (n=53, 23.2%) had lower systolic blood pressure
(BP) than patients without diabetes (155±17 vs 161±16 mm Hg, p=0.03), they
had lower e′ velocity (5.7±1.5 vs 6.1±1.4 cm/s, p=0.04) at baseline.
Azelnidipine decreased BP and heart rate, and increased e′ velocity
similarly in patients with diabetes (5.7±1.5 to 6.3±1.5 cm/s, p=0.0003)
and without diabetes (6.1±1.4 to 6.9±1.4 cm/s, p<0.0001). Increase
in e′ velocity was not influenced by presence of diabetes, and patients
with diabetes still had lower e′ velocity after treatment (p=0.006). There
was a significant correlation between increase in e′ velocity and decrease
in systolic BP (R=0.25, p=0.0001), which was not influenced by diabetes.
Conclusions: Comorbid diabetes could impair left ventricular relaxation
independently in patients with hypertension, which might not be improved
solely by BP lowering.