Increased augmentation of central blood pressure is associated with increases in carotid intima–media thickness in type 2 diabetic patients

Abstract

Aims/hypothesis: Type 2 diabetes is associated with a two-to seven-fold increase in cardiovascular morbidity and mortality. The aim of this study was to determine the relationships between intima-media thickness (IMT), an established marker of atherosclerosis, large artery function and other determinants of cardiovascular risk in type 2 diabetic patients. Methods: We studied 228 type 2 diabetic patients (75 women, aged 62±2 years [mean± SEM]). Carotid IMT was bilaterally measured using ultrasound technology. Applanation tonometry and pulse wave analysis were used to measure aortic systolic and diastolic blood pressures, central pressure augmentation (AG) and the augmentation index (AIx), a measure of systemic arterial stiffness. Conventional cardiovascular risk factors (lipids, HbA 1 c, smoking and diabetes duration) were also assessed. Results: Women had higher AG and AIx (p<0.0001), despite comparable systolic BP and heart rate in women and men. In women, AG (r=0.39, p<0.001), age (r=0.32, p<0.01), brachial systolic BP (r=0.34, p< 0.01) and aortic systolic BP (r=0.34, p<0.01) correlated with IMT. In men, age (r=0.41, p<0.001), diabetes duration (r=0.25, p<0.01), AG (r=0.22, p<0.01), aortic systolic BP (r=0.21, p<0.01), brachial systolic BP (r=0.21, p<0.01) and body weight (r=0.16, p<0.05) correlated with IMT. In multiple linear regression analyses, AG and aortic systolic BP, but not brachial systolic BP, were age-independent determinants of IMT in men and women. In all patients, increased AG (adjusted for sex, age and heart rate) correlated with longer duration of diabetes, urinary albumin excretion and IMT. Conclusions/interpretation: Measures of central systolic pressure correlate with carotid IMT, independently of age and other risk markers.

Effect of age and Blood Pressure on Surrogate Markers of Atherosclerosis in Patients with Type 2 Diabetes Mellitus

“…This is in accordance with findings by Westerbacka et al, [20] which also showed that increased augmentation pressure correlated with duration of diabetes.…”

Insulin resistance and arterial stiffness: impact of gestational diabetes on pulse wave velocity

“…[28][29][30][31][32][33] Furthermore, several studies have reported that alteration of arterial stiffness occur in subjects with impaired glucose tolerance, polycystic ovaries, and newly diagnosed type 2 diabetes. [34][35][36] Moreover, in our study, we found a correlation between PWVft and insulinresistance state of GDM women, as assessed by the level of HOMA-IR index. In other words, pregnancies complicated by insulin resistance are independently associated with enhancement of maternal arterial stiffness.…”

The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients

“…4 There is now established evidence that aortic stiffness increases with aging and prolonged elevation of blood pressure, 5 and is the underlying pathology of isolated systolic hypertension. 6 Aortic stiffness is closely associated with cerebral large-arterial disease involving the extracranial internal carotid [7][8][9] and intracranial large arteries. 10 It is not possible to study the direct association of aortic stiffness with changes in cerebral microvessels, which cannot be routinely assessed with current imaging technology.…”