P7.5 Relationships Between 24 Hour Urinary Cortisol Metabolites and Structural Cardiac and Arterial Indices in People with or at Risk of Type 2 Diabetes

Purpose Testosterone levels are decreased in hypertensive patients compared to normotensive subjects with similar age. Measurements of carotid IMT or aortic stiffness are reasonable for detecting vascular organ damage (OD) in patients with arterial hypertension. We investigated whether low testosterone concentration is associated with vascular OD in hypertensive patients. Methods 178 consecutive asymptomatic hypertensive males (40−60 y/o) were evaluated using exercise treadmill test and stress echocardiography. Men with positive one or both of the two tests were referred for coronary angiography in order to document coronary artery disease (CAD). All patients underwent carotid-femoral pulse wave velocity (PWV) and carotid IMT evaluation. Vascular OD was detected when IMT>0.9 mm (or plaque) and/or PWV>10 m/s. Total testosterone (TT) levels were measured in all participants. Testosterone deficiency (TD) was defined when TT levels were below 3.4 ng/ml. Results Coronary angiography revealed significant stenosis in 31 (17%) patients. The prevalence of Grade II/III hypertension was not different between CAD patients and subjects without CAD. Subjects without CAD were further divided according to presence/absence of vascular OD. Patients with vascular OD had lower TT level (p<0.001) and a greater prevalence of TD (p<0.01) compared to hypertensive subjects without OD after adjustment for age and blood pressure. Interestingly, CAD patients and non CAD subjects with vascular OD had comparable TT concentration and prevalence of TD. Conclusion TT concentration is decreased in hypertensive patients with vascular OD compared to subjects without OD. These findings underscore the predictive value of TD in hypertensive males with OD.