Blood pressure reduction due to hemoglobin glycosylation in type 2 diabetic patients

Pedro Cabrales¹, Miguel A Salazar Vázquez^2,3, Beatriz Y Salazar Vázquez^3,4, Martha Rodríguez-Morán⁵, Marcos Intaglietta⁴, Fernando Guerrero-Romero⁵

¹La Jolla Bioengineering Institute, La Jolla, California, USA; ²Hospital Regional No. 1, of the Mexican Social Security Institute, Victoria de Durango, Dgo. Mexico; ³Faculty of Medicine and Dept. of Physical Chemistry, Universidad Juárez del Estado de Durango, Victoria de Durango, Dgo. Mexico; ⁴Department of Bioengineering, University of California, San Diego, La Jolla, California, USA; ⁵Biomedical Research Unit, of the Mexican Social Security Institute, Victoria de Durango, Dgo. Mexico

Objective: To test the hypothesis that glycosylation of hemoglobin constitutes a risk factor for hypertension.

Methods: A total of 129 relative uniform diabetic subjects (86 women and 42 men) were enrolled in a cross-sectional study. Exclusion criteria included alcohol consumption, smoking, ischemic heart disease, stroke, neoplasia, renal, hepatic, and chronic inflammatory disease. Systolic and diastolic pressures were recorded in subsequent days and mean arterial blood pressure (MAP) was determined. Hemoglobin glycosylation was measured by determining the percentage glycosylated hemoglobin (HbA1c) by means of the automated microparticle enzyme immunoassay test.

Results: MAP was found to be independent of the concentration of HbA1c; however, correcting MAP for the variability in hematocrit, to evidence the level of vasoconstriction (or vasodilatation) showed that MAP is negatively correlated with the concentration of HbA1c (p for trend <0.05), when patients treated for hypertension are excluded from the analysis. Patients treated for hypertension showed the opposite trend with increasing MAP as HbA1c increased (p for the difference in trends <0.05).

Conclusions: Glycosylation per se appears to lead to blood pressure reduction in type 2 diabetic patients untreated for hypertension. Treatment for hypertension may be associated with a level of endothelial dysfunction that interferes with the antihypertensive effect of HbA1c.

Keywords: diabetes, hemoglobin glycosylation, hypertension, hematocrit, nitric oxide