A 48-Year-Old Man with Diet-Controlled Type 2 Diabetes Mellitus Is

A 48-year-old man with diet-controlled type 2 diabetes mellitus is being evaluated for occasional retrosternal chest pain.  He has no history of hypertension, and his blood pressure measurements during office visits were always within normal limits.  There is no family history of cardiovascular disease.  The patient undergoes exercise treadmill stress testing.  He walks for 7 minutes on the treadmill and stops due to fatigue but does not experience chest pain.  His ECG does not show any abnormal changes.  Heart rate ranges from 70/min at rest to 132/min at peak and mean blood pressure ranges from 95 mm Hg at rest to 112 mm Hg at peak.  Which of the following parameters was most likely decreased during peak stress compared to the resting state in this patient?

A) Cardiac output
B) Left ventricular end-diastolic pressure
C) Pulmonary artery systolic pressure
D) Systemic systolic blood pressure
E) Total systemic vascular resistance

Correct Answer:

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