Diabetes Clinical Trial
Official title:
Central Blood Pressure and Pulse Wave Velocity: Relationship to Target Organ Damage and Cardiovascular Morbidity-mortality in Diabetic Patients. An Observational Prospective Study. LOD-DIABETES: Study Protocol
Diabetic patients show an increased prevalence of non dipping arterial pressure pattern,
target organ damage and elevated arterial stiffness. These alterations are associated with
increased cardiovascular risk.
The objectives of this study are the following: to evaluate the prognostic value of central
arterial pressure and pulse wave velocity in relation to the incidence and outcome of target
organ damage and the appearance of cardiovascular episodes (cardiovascular mortality,
myocardial infarction, chest pain and stroke) in patients with type 2 diabetes mellitus.
METHODS/DESIGN:
Type of study: This is an observational prospective study with a duration of 5 years, of
which the first year corresponds to patient inclusion and initial evaluation, and the
remaining four years to follow-up.
Setting: The study will be carried out in the urban primary care setting. Study population:
Consecutive sampling will be used to include patients diagnosed with type 2 diabetes between
20-80 years of age. A total of 110 patients meeting all the inclusion criteria and none of
the exclusion criteria will be included.
Measurements: Patient age and sex, family and personal history of cardiovascular disease, and
cardiovascular risk factors. Height, weight, heart rate and abdominal circumference.
Laboratory tests: hemoglobin, lipid profile, creatinine, microalbuminuria, glomerular
filtration rate, blood glucose, glycosylated hemoglobin, blood insulin, fibrinogen and high
sensitivity C reactive protein. Clinical and 24-hour ambulatory (home) blood pressure
monitoring and self-measured blood pressure. Common carotid artery ultrasound for the
determination of mean carotid intima-media thickness. Electrocardiogram for assessing left
ventricular hypertrophy. Ankle-brachial index. Retinal vascular study based on funduscopy
with non-mydriatic retinography and evaluation of pulse wave morphology and pulse wave
velocity using the SphygmoCor system. The medication used for diabetes, arterial hypertension
and hyperlipidemia will be registered, together with antiplatelet drugs.
DISCUSSION: The results of this study will help to know and quantify the prognostic value of
central arterial pressure and pulse wave velocity in relation to the evolution of the
subclinical target organ damage markers and the possible incidence of cardiovascular events
in patients with type 2 diabetes mellitus.
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