Cardiovascular Endocrinology

Skip Navigation LinksHome > September 2014 - Volume 3 - Issue 3 > Acute cardiometabolic responses facilitating a state of chro...
Cardiovascular Endocrinology:
doi: 10.1097/XCE.0000000000000019
Original articles

Acute cardiometabolic responses facilitating a state of chronic hyperglycemia and renal impairment: the SABPA study

Joosten, Liezla; Malan, Leonéa; Uys, Aletta S.a; Alkerwi, Ala’ab; Malan, Nico T.a

Collapse Box


Background: Augmented α-adrenergic response patterns are associated with vascular risk in Africans. Therefore, the aims of this study were (a) to assess ethnic differences related to glucose and cardiovascular responses during acute laboratory stress, and (b) to assess whether these responses are associated with chronic hyperglycemia (HbA1c≥5.7%) and albumin : creatinine ratio (ACR).

Materials and methods: Ambulatory blood pressure of 81 African and 100 Caucasian men was recorded. Beat-to-beat blood pressure was obtained during exposure to the Color Word Conflict (STROOP) and Cold Pressor Tests (CPT). Overnight 8 h fasting urine, basal and post-stress blood samples were collected for biochemical analyses.

Results: Augmented glucose responses (P<0.001) were shown by the African men in response to the STROOP and CPT, in contrast to their Caucasian counterparts, who showed attenuated responses. In hyperglycemic African men, an enhanced α-adrenergic profile was revealed, with decreased stroke volume (P=0.07) and cardiac output responses (P=0.05). Augmented systolic blood pressure changes during the CPT predicted elevated ACR in African men [adjusted R2 0.31: β, 0.54 (0.23, 0.85), P=0.002]. In hyperglycemic Caucasian men, however, metabolic changes, that is augmented glucose changes to the STROOP test, predicted elevated ACR [adjusted R2 0.19: β, 0.33 (0.02, 0.64), P=0.04].

Conclusion: An α-adrenergic-driven cardiovascular response profile acted in tandem with augmented glucose responses in African men when exposed to acute laboratory stress. Pressure overload in Africans in contrast to metabolic responses in Caucasians may suggest different underlying mechanisms for ACR, a marker of renal impairment, when in a state of chronic hyperglycemia.

© 2014Wolters Kluwer Health Lippincott Williams Wilkins

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.