{"id":31249,"date":"2020-04-17T13:57:47","date_gmt":"2020-04-17T08:27:47","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=31249"},"modified":"2020-04-17T13:57:47","modified_gmt":"2020-04-17T08:27:47","slug":"risk-of-hypoglycemia-in-cardiovascular-disease","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/risk-of-hypoglycemia-in-cardiovascular-disease\/","title":{"rendered":"Risk of hypoglycemia in cardiovascular disease"},"content":{"rendered":"<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/8rTUVmQWHRs\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Risk of hypoglycemia in cardiovascular disease<\/span><\/h2>\n<p>Risk of hypoglycemia in cardiovascular disease can be at various levels. Though good long term control of diabetes mellitus is beneficial in those with cardiovascular disease, episodes of hypoglycemia has been shown to be deleterious. It has been associated with elevated cardiac troponins, though it has been questioned whether it is due to hypoglycemia per se or the more severe diabetes mellitus in these patients [1].<\/p>\n<p>Severe hypoglycemia leads to sympathetic overactivity resulting in tachycardia, increased peripheral resistance, increased systemic blood pressure and enhanced myocardial contractility. All these can worsen myocardial ischemia and injury (as documented by elevated troponin), more so in those with pre-existing coronary artery disease [2].<\/p>\n<p>Acute hypoglycemia may lead to release of vasoactive substances leading to vascular injury [3]. This may be mediated by the release of catecholamines and other neurohormonal peptides in severe hypoglycemia. Increased levels of biomarkers, cell adhesion molecules, enhanced blood viscosity and platelet aggregation may promote a thrombogenic milieu leading to myocardial infarction [2].<\/p>\n<p>Severe hypoglycemia may be associated with severe hypertension, hypokalemia and prolongation of QT interval [4]. This could lead on to life threatening ventricular arrhythmias.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li style=\"list-style-type: none;\">\n<ol>\n<li>Rezende PC, Everett BM, Brooks MM, Vlachos H, Orchard TJ, Frye RL, Bhatt DL, Hlatky MA. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30286920\">Hypoglycemia and Elevated Troponin in Patients With Diabetes and Coronary Artery Disease<\/a>. J Am Coll Cardiol. 2018 Oct 9;72(15):1778-1786.<\/li>\n<li>Deedwania P. <a href=\"http:\/\/www.onlinejacc.org\/content\/72\/15\/1787\">Dangers of Hypoglycemia in Cardiac Patients With Diabetes: Time to Switch to Safer, Newer Drugs<\/a>. J Am Coll Cardiol. 2018 Oct 9;72(15):1787-1789.<\/li>\n<li>Wright RJ, Newby DE, Stirling D, Ludlam CA, Macdonald IA, Frier BM. <a href=\"https:\/\/care.diabetesjournals.org\/content\/33\/7\/1591\">Effects of acute insulin-induced hypoglycemia on indices of inflammation: putative mechanism for aggravating vascular disease in diabetes<\/a>. Diabetes Care. 2010 Jul;33(7):1591-7.<\/li>\n<li>Tsujimoto T, Yamamoto-Honda R, Kajio H, Kishimoto M, Noto H, Hachiya R, Kimura A, Kakei M, Noda M. <a href=\"https:\/\/care.diabetesjournals.org\/content\/37\/1\/217\">Vital signs, QT prolongation, and newly diagnosed cardiovascular disease during severe hypoglycemia in type 1 and type 2 diabetic patients<\/a>. Diabetes Care. 2014;37(1):217-25.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Risk of hypoglycemia in cardiovascular disease Risk of hypoglycemia in cardiovascular disease can be at various levels. Though good long term control of diabetes mellitus is beneficial in those with cardiovascular disease, episodes of hypoglycemia has been shown to be deleterious. It has been associated with elevated cardiac troponins, though it has been questioned whether [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":31262,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-31249","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Risk of hypoglycemia in cardiovascular disease - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"description\" content=\"Risk of hypoglycemia in cardiovascular disease can be at various levels. Elevation of cardiac troponins with severe hypoglycemia has been documented.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/risk-of-hypoglycemia-in-cardiovascular-disease\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Risk of hypoglycemia in cardiovascular disease - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Risk of hypoglycemia in cardiovascular disease can be at various levels. Elevation of cardiac troponins with severe hypoglycemia has been documented.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/risk-of-hypoglycemia-in-cardiovascular-disease\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2020-04-17T08:27:47+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Risk of hypoglycemia in cardiovascular disease\",\"datePublished\":\"2020-04-17T08:27:47+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/\"},\"wordCount\":323,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/\",\"name\":\"Risk of hypoglycemia in cardiovascular disease - All About Cardiovascular System and Disorders\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/risk-of-hypoglycemia-in-cardiovascular-disease\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2020-04-17T08:27:47+00:00\",\"description\":\"Risk of hypoglycemia in cardiovascular disease can be at various levels. 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