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Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications
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Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (25 October 2024) | Viewed by 9368

Special Issue Editor

Dr. George Pavlidis

E-Mail Website1 Website2
Guest Editor
Laboratory of Preventive Cardiology, 2nd Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Interests: endothelial function; arterial stiffness; left ventricular myocardial function; atherosclerosis; oxidative stress; diabetes; chronic inflammatory diseases

Special Issue Information

Dear Colleagues,

This Special Issue on "Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications" aims to provide a clinical perspective and address key challenges in the management of these chronic conditions. It seeks to bridge the gap between research findings and their practical implementation in clinical settings.

Diabetes, hypertension, and cardiovascular disease pose significant burdens on healthcare systems globally, demanding a thorough understanding of their management. Despite advancements in medical knowledge and treatments, healthcare professionals continue to face persistent difficulties in effectively managing these conditions.

This Special Issue covers a wide range of clinical topics, including:

  1. Evidence-based clinical strategies and interventions for optimal management of diabetes, hypertension, and cardiovascular disease.
  2. Innovative diagnostic tools and technologies for early detection, risk assessment, and monitoring.
  3. Advancements in pharmacological and non-pharmacological approaches to enhance treatment outcomes.
  4. Lifestyle modifications, dietary interventions, and tailored physical activity recommendations.
  5. Strategies to promote patient compliance and self-care practices.
  6. Implications for health policy and system-level interventions to optimize clinical care.

By mobilizing contributions from researchers and clinicians, this Special Issue aims to facilitate the exchange of clinical insights and implications in the management of diabetes, hypertension, and cardiovascular disease. Through the dissemination of practical knowledge and evidence-based approaches, it aims to enhance patient care and outcomes in these interconnected chronic conditions.

Dr. George Pavlidis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diabetes
  • hypertension
  • cardiovascular disease
  • chronic conditions
  • clinical management

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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13 pages, 599 KiB  
Article
The Prevalence and Characteristics of Anemia in Romanian Patients with Type 2 Diabetes: A Cross-Sectional Study
by Laura Gaita, Bogdan Timar, Sandra Lazar, Simona Popescu, Oana Albai, Adina Braha and Romulus Timar
J. Clin. Med. 2024, 13(23), 7306; https://doi.org/10.3390/jcm13237306 - 1 Dec 2024
Viewed by 1056
Abstract
Background/Objectives: Anemia is a prevalent comorbidity of diabetes, and although various mechanisms have been shown to link these two conditions, their interaction has not been sufficiently explored. Our cross-sectional, non-interventional study aimed to evaluate the prevalence of anemia and its subtypes, as well [...] Read more.
Background/Objectives: Anemia is a prevalent comorbidity of diabetes, and although various mechanisms have been shown to link these two conditions, their interaction has not been sufficiently explored. Our cross-sectional, non-interventional study aimed to evaluate the prevalence of anemia and its subtypes, as well as their interactions, in patients with type 2 diabetes (T2D). Methods: A total of 227 patients previously diagnosed with T2D were enrolled. These patients were assessed regarding their medical history and the evolution of their diabetes, and were screened for anemia. Results: Anemia was encountered in 32.6% of the 227 hospitalized patients previously diagnosed with T2D enrolled in this study. Its presence was associated with a higher prevalence of complications and comorbidities, such as chronic kidney disease (CKD), retinopathy, and atrial fibrillation. The most common types of anemia observed were those associated with CKD, other chronic conditions, and iron deficiency. A moderate, positive correlation (r = 0.307; p < 0.0001) has been observed between estimated glomerular filtration rate (eGFR) and hemoglobin, and a moderate, negative correlation has been observed between age and hemoglobin (r = −0.351; p < 0.0001), with the results also analyzed using multiple regression and ROC curve analysis. Additionally, a weak, positive, yet statistically significant correlation was observed between glycemic values and hemoglobin levels, which requires further research. Conclusions: Anemia is frequently encountered in patients with T2D, especially in those with increased age, decreased eGFR, and additional chronic degenerative complications or other comorbidities; thus, a systematic screening for an early diagnosis and interdisciplinary management is recommended for improved outcomes related to morbidity, mortality, and quality of life. Full article
(This article belongs to the Special Issue Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications)
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13 pages, 3726 KiB  
Article
Impact of Hypertension and Physical Exercise on Hemolysis Risk in the Left Coronary Artery: A Computational Fluid Dynamics Analysis
by Krystian Jędrzejczak, Wojciech Orciuch, Krzysztof Wojtas, Piotr Piasecki, Jerzy Narloch, Marek Wierzbicki, Michał Kozłowski, Malenka M. Bissell and Łukasz Makowski
J. Clin. Med. 2024, 13(20), 6163; https://doi.org/10.3390/jcm13206163 - 16 Oct 2024
Viewed by 1433
Abstract
Background and Objectives: Hypertension increases the risk of developing atherosclerosis and arterial stiffness, with secondarily enhanced wall stress pressure that damages the artery wall. The coexistence of atherosclerosis and hypertension leads to artery stenosis and microvascular angiopathies, during which the intravascular mechanical [...] Read more.
Background and Objectives: Hypertension increases the risk of developing atherosclerosis and arterial stiffness, with secondarily enhanced wall stress pressure that damages the artery wall. The coexistence of atherosclerosis and hypertension leads to artery stenosis and microvascular angiopathies, during which the intravascular mechanical hemolysis of red blood cells (RBCs) occurs, leading to increased platelet activation, dysfunction of the endothelium and smooth muscle cells due to a decrease in nitric oxide, and the direct harmful effects of hemoglobin and iron released from the red blood cells. This study analyzed the impact of hypertension and physical exercise on the risk of hemolysis in the left coronary artery. Methods: To analyze many different cases and consider the decrease in flow through narrowed arteries, a flow model was adopted that considered hydraulic resistance in the distal section, which depended on the conditions of hypertension and exercise. The commercial ANSYS Fluent 2023R2 software supplemented with user-defined functions was used for the simulation. CFD simulations were performed and compared with the FSI simulation results. Results: The differences obtained between the FSI and CFD simulations were negligible, which allowed the continuation of analyses based only on CFD simulations. The drops in pressure and the risk of hemolysis increased dramatically with increased flow associated with increased exercise. A relationship was observed between the increase in blood pressure and hypertension, but in this case, the increase in blood pressure dropped, and the risk of hemolysis was not so substantial. However, by far, the case of increased physical activity with hypertension had the highest risk of hemolysis, which is associated with an increased risk of clot formation that can block distal arteries and lead to myocardial hypoxia. Conclusions: The influence of hypertension and increased physical exercise on the increased risk of hemolysis has been demonstrated. Full article
(This article belongs to the Special Issue Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications)
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10 pages, 1043 KiB  
Article
The Predictive Value of Global Longitudinal and Circumferential Strains in Hypertensive Patients: 10-Year Follow-Up
by Marijana Tadic, Tamara Filipovic, Jelena Suzic, Anka Majstorovic, Biljana Pencic, Vladan Vukomanovic, Cesare Cuspidi and Vera Celic
J. Clin. Med. 2024, 13(19), 5799; https://doi.org/10.3390/jcm13195799 - 28 Sep 2024
Cited by 4 | Viewed by 1046
Abstract
Background: The aim of the current study was to investigate the predictive value of a multidirectional LV strain on adverse outcomes in a large population of uncomplicated hypertensive patients who were followed for a mean period of 10 years. Methods: This retrospective study [...] Read more.
Background: The aim of the current study was to investigate the predictive value of a multidirectional LV strain on adverse outcomes in a large population of uncomplicated hypertensive patients who were followed for a mean period of 10 years. Methods: This retrospective study included 591 recently diagnosed hypertensive patients who underwent clinically indicated echocardiography between January 2010 and December 2014 and were followed for a mean period of 10 years. Global longitudinal, circumferential and radial strains (GLS, GCS and GRS) were measured by 2D speckle tracking imaging. The primary outcome was a MACE occurrence defined by all-cause mortality, cardiovascular mortality, myocardial infarction, coronary artery by-pass, coronary stent implantation, stroke, development of heart failure and the occurrence of atrial fibrillation during follow-up. Results: Our results showed that GLS, GCS and GRS were significantly lower in patients who experienced MACE. Age, male gender, systolic blood pressure, left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) were associated with MACE occurrence. Reduced GLS [OR 1.15; 95%CI: 1.01–1.30] and reduced GCS [OR 1.1; 95%CI: 1.02–1.22] were related with MACE independently of clinical characteristics, LV systolic and diastolic function, as well as LVH. Reduced GRS was not independently associated with adverse outcomes. Conclusions: Reduced GLS and GCS were independently associated with adverse outcomes during 10-year follow-up in patients who were recently diagnosed and uncomplicated hypertensive patients at the baseline. Full article
(This article belongs to the Special Issue Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications)
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16 pages, 611 KiB  
Systematic Review
Antidiabetic Treatment and Prevention of Ischemic Stroke: A Systematic Review
by Vasiliki Prentza, George Pavlidis, Ignatios Ikonomidis, Sotirios Pililis, Stamatios Lampsas, Aikaterini Kountouri, Loukia Pliouta, Emmanouil Korakas, John Thymis, Lina Palaiodimou, Aikaterini Tsegka, Konstantinos Markakis, Panagiotis Halvatsiotis, Georgios Tsivgoulis and Vaia Lambadiari
J. Clin. Med. 2024, 13(19), 5786; https://doi.org/10.3390/jcm13195786 - 28 Sep 2024
Cited by 2 | Viewed by 2342
Abstract
Background: Diabetes mellitus (DM) is a prevalent disease in the general population and also a well-established risk factor for the development of ischemic stroke. Patients who have been diagnosed with diabetes have a 20% higher risk for developing ischemic stroke in comparison to [...] Read more.
Background: Diabetes mellitus (DM) is a prevalent disease in the general population and also a well-established risk factor for the development of ischemic stroke. Patients who have been diagnosed with diabetes have a 20% higher risk for developing ischemic stroke in comparison to non-diabetic individuals. The aim of the current systematic review is to provide the latest evidence regarding the association between antidiabetic treatment and the prevention of ischemic stroke. Methods: A comprehensive search in scientific literature databases PUBMED, COCHRANE, and SCOPUS was conducted. The studies that were deemed as eligible for this review were those that examined the clinical benefits of therapeutic strategies in terms of preventing ischemic strokes. Results: A total of 32 studies met the established selection criteria. The included studies showed that pioglitazone treatment significantly reduced the risk for recurrent stroke in patients with DM. Furthermore, in the context of primary prevention, the improvement in glycemic control after treatment with the glucagon-like peptide-1 receptor agonists (GLP-1RA) semaglutide and dulaglutide was associated with a reduction in the risk of ischemic stroke in diabetic subjects. Metformin monotherapy may reduce stroke risk, while dipeptidyl peptidase 4 inhibitors, sodium-glucose co-transporter 2 inhibitors, and insulin do not seem to affect the incidence of stroke. Conclusions: The findings of the present systematic review suggest that pioglitazone and GLP-1RA may decrease the risk of stroke. Further studies are needed to provide additional data regarding the preventive effect of novel antidiabetic drugs, such as dual glucose-dependent insulinotropic polypeptide/GLP-1RA agents, on stroke. Full article
(This article belongs to the Special Issue Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications)
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15 pages, 2131 KiB  
Systematic Review
Efficacy and Safety of Low-Dose Bisoprolol/Hydrochlorothiazide Combination for the Treatment of Hypertension: A Systematic Review and Meta-Analysis
by Arrigo F. G. Cicero, Naif Saad ALGhasab, Giuliano Tocci, Giovambattista Desideri, Giulia Fiorini and Federica Fogacci
J. Clin. Med. 2024, 13(15), 4572; https://doi.org/10.3390/jcm13154572 - 5 Aug 2024
Viewed by 2627
Abstract
Objectives: This systematic review and meta-analysis aimed to assess the blood pressure (BP)-lowering effect and the safety profile of low-dose bisoprolol/hydrochlorothiazide combination treatment in patients with hypertension. Methods: Multiple electronic databases were systematically searched, and five clinical studies were included in the meta-analysis. [...] Read more.
Objectives: This systematic review and meta-analysis aimed to assess the blood pressure (BP)-lowering effect and the safety profile of low-dose bisoprolol/hydrochlorothiazide combination treatment in patients with hypertension. Methods: Multiple electronic databases were systematically searched, and five clinical studies were included in the meta-analysis. Results: Treatment with bisoprolol/hydrochlorothiazide significantly reduced systolic BP (SBP) [mean difference (MD): −8.35 mmHg, 95% confidence interval (CI): −11.44, −5.25 mmHg versus control; MD: −9.88 mmHg, 95%CI: −12.62, −7.14 mmHg versus placebo] and diastolic BP (DBP) [MD: −7.62 mmHg, 95%CI: −11.20, −4.04 mmHg, versus control; MD: −8.79 mmHg, 95%CI: −11.92, −5.67 mmHg versus placebo]. Moreover, BP response rate and BP control rate after low-dose bisoprolol/hydrochlorothiazide combination treatment were significantly greater compared to control [odd ratio (OR) for response rate: 4.86, 95%CI: 2.52, 9.37; OR for control rate: 1.67, 95%CI: 1.11, 2.51]. Finally, treatment with low-dose bisoprolol/hydrochlorothiazide was associated with a reduced risk of any adverse event (AE) and peripheral edema compared to control. Conclusions: Overall, our results reaffirm the safety and efficiency of prescribing bisoprolol/hydrochlorothiazide combination treatment in stage I and II hypertension. Full article
(This article belongs to the Special Issue Managing Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Implications)
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