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Öğe The relationship between exercise capacity and masked hypertension in sedentary patients with diabetes mellitus(Taylor & Francis Inc, 2014) Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Tekinalp, Mehmet; Ayhan, Selim Suzi; Gunduz, Mehmet; Alibasic, HajrudinAim: Although exaggerated blood pressure responses (EBPR) to exercise have been related to future hypertension and masked hypertension (MHT), the relationship between exercise capacity and MHT remains unclear. A sedentary life style has been related to increased cardiovascular mortality, diabetes mellitus (DM), and hypertension. In this study, we aimed to examine the relationship between exercise capacity and MHT in sedentary patients with DM. Methods: This study included 85 sedentary and normotensive patients with DM. Each patient's daily physical activity level was assessed according to the INTERHEART study. All patients underwent an exercise treadmill test, and exercise duration and capacity were recorded. Blood pressure (BP) was recorded during all exercise stages and BP values >= 200/110 mmHg were accepted as EBPR. MHT was diagnosed in patients having an office BP < 140/90 mmHg and a daytime ambulatory BP > 135/85 mmHg. Patients were divided into two groups according to their ambulatory BP monitoring (MHT and normotensive group). Results: The prevalence of MHT was 28.2%. Exercise duration and capacity were lower in the MHT group than in the normotensive group (p < 0.05) and were negatively correlated with age, HbA1c, mean daytime BP, and mean 24 hour BP. Peak exercise systolic BP and the frequency of EBPR were both increased in the MHT group (25.0% and 8.1%, respectively, p = 0.03). According to a multivariate regression, exercise capacity (OR: 0.61, CI95%: 0.39-0.95, p = 0.03), EBPR (OR: 9.45, CI95%: 1.72-16.90, p = 0.01), and the duration of DM (OR: 0.84, CI95%: 0.71-0.96, p = 0.03) were predictors of MHT. Conclusion: Exercise capacity, EBPR, and the duration of DM were predictors of MHT in sedentary subjects with DM.Öğe The relationship between serum asymmetric dimethylarginine levels and subjective sleep quality in normotensive patients with type 2 diabetes mellitus(Korean Assoc Internal Medicine, 2015) Aribas, Alpay; Kayrak, Mehmet; Tekinalp, Mehmet; Akilli, Hakan; Alibasic, Hayrudin; Yildirim, Serkan; Gunduz, MehmetBackground/Aims: Poor sleep quality (SQ) is associated with increased cardiovascular mortality and morbidity. Additionally, asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular mortality and morbidity. However, no sufficient data regarding the relationship between ADMA levels and SQ have been reported. The goal of the current study was to evaluate the association between SQ and ADMA levels in normotensive patients with type 2 diabetes mellitus. Methods: The study participants consisted of 78 normotensive type 2 diabetics. The SQ of all participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Patients with a global PSQI score > 5 were defined as poor sleepers. Factors associated with poor SQ were analyzed using a multiple regression model. Serum ADMA levels were measured using high performance liquid chromatography. Results: The median ADMA levels of the poor sleepers were increased compared with patients defined as good sleepers (5.5 [4.2 to 6.6] vs. 4.4 [2.9 to 5.4], p < 0.01, respectively). However, the L-arginine/ADMA ratio was decreased in poor sleepers (p < 0.01). Global PSQI scores were positively correlated with ADMA levels (p < 0.01) and negatively correlated with the L-arginine/ADMA ratio (p = 0.02). ADMA levels were correlated with sleep latency (p < 0.01) and sleep efficiency (p = 0.01). Logistic regression analysis showed that ADMA levels (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.16 to 2.44; p = 0.01) and body mass index (OR, 1.15; 95% CI, 1.01 to 1.31; p = 0.04) were associated with poor SQ independently of glomerular filtration rate, sex, age, duration of diabetes, hemoglobin A1c, total cholesterol, and systolic blood pressure. Conclusions: Self-reported SQ was independently associated with ADMA levels in normotensive patients with diabetes mellitus.Öğe The relationship between white coat hypertension and sleep quality(Springer Japan Kk, 2014) Kaya, Zeynettin; Kayrak, Mehmet; Demir, Kenan; Gunduz, Mehmet; Alibasic, Hayruddin; Karanfil, Mustafa; Akilli, HakanImpaired sleep quality is frequently associated with hypertension. The present study aims to examine self-reported sleep quality of patients with white coat hypertension. A total of 74 subjects who were evaluated in a cardiology outpatient clinic, including 39 normotensive subjects and 35 patients with white coat hypertension between the ages of 20 and 65 were included in this study. Patients with elevated office blood pressure (>= 140/90 mm Hg) and normal 24-h and daytime ambulatory blood pressure (<125/80 mm Hg and <130/85 mm Hg, respectively) were defined as white coat hypertension. Patient's sleep quality was evaluated using the Pittsburgh sleep quality index. Global Pittsburgh sleep quality index score was significantly higher in patients with white coat hypertension than normotensive subjects (7.2 +/- 3.7 vs. 5.1 +/- 3.8, P = 0.01). Poor sleep quality was present in 65% of patients with white coat hypertension, and in 30% of the normotensive group (P = 0.003). A multiple logistic regression analysis showed that white coat hypertension (odds: 6.7 (95% confidence interval [CI] 1.22-36.64), P = 0.03) and female gender (odds: 10.1(95% CI 1.35-76.32), P = 0.02) were independent predictors of poor sleep quality. In conclusion, white coat hypertension seems to be associated with impaired sleep quality.Öğe The Role of Ischemia Modified Album in Acute Pulmonary Embolism(Elsevier Science Inc, 2013) Kaya, Zeynettin; Kayrak, Mehmet; Gul, Enes Elvin; Altunbas, Gokhan; Toker, Aysun; Kiyici, Aysel; Gunduz, Mehmet[Abstract Not Availabe]Öğe White Coat Hypertension and Poor Sleep Quality(Elsevier Science Inc, 2013) Kaya, Zeynettin; Kayrak, Mehmet; Demir, Kenan; Gunduz, Mehmet; Alibasic, Hayruddin; Karanfil, Mustafa; Akilli, Hakan[Abstract Not Availabe]
