The Pulse Wave Velocity as an Early Indicator of Atherosclerosis in Diabetic Subjects

Woolam, Gerald L.; Schnur, Paul; Vallbona, Carlos; Hoff, Hebbel E.

doi:10.1161/01.cir.25.3.533

Cited by 152 publications

(70 citation statements)

References 13 publications

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“…Early methods suggested PWV was faster in type 2 diabetes than in controls. 14,15 As in the present study's baseline data, 16 others reported worse aortic compliance or distensibility in type 2 diabetes than in controls in smaller clinical studies. 17,18 Structural indices such as carotid intima-media thickness also show excess disease in those with diabetes.…”

Section: Discussionsupporting

confidence: 67%

Aortic Pulse-Wave Velocity and Its Relationship to Mortality in Diabetes and Glucose Intolerance

et al. 2002

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Background-Arterial distensibility measures, generally from pulse-wave velocity (PWV), are widely used with little knowledge of relationships to patient outcome. We tested whether aortic PWV predicts cardiovascular and all-cause mortality in type 2 diabetes and glucose-tolerance-tested (GTT) multiethnic population samples. Methods and Results-Participants were randomly sampled from (1) a type 2 diabetes outpatient clinic and (2) primary care population registers, from which nondiabetic control subjects were given a GTT. Brachial blood pressures and Doppler-derived aortic PWV were measured. Mortality data over 10 years' follow-up were obtained. At any level of systolic blood pressure (SBP), aortic PWV was greater in subjects with diabetes than in controls. Mortality risk doubled in subjects with diabetes (hazard ratio 2.34, 95% CI 1.5 to 3.74) and in those with glucose intolerance (2.12, 95% CI 1.11 to 4.0) compared with controls. For all groups combined, age, sex, and SBP predicted mortality; the addition of PWV independently predicted all-cause and cardiovascular mortality (hazard ratio 1.08, 95% CI 1.03 to 1.14 for each 1 m/s increase) but displaced SBP. Glucose tolerance status and smoking were other independent contributors, with African-Caribbeans experiencing reduced mortality risk (hazard ratio 0.41, 95% CI 0.25 to 0.69). Conclusions-Aortic PWV is a powerful independent predictor of mortality in both diabetes and GTT population samples.In displacing SBP as a prognostic factor, aortic PWV is probably further along the causal pathway for arterial disease and may represent a useful integrated index of vascular status and hence cardiovascular risk.

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Section: Discussionsupporting

confidence: 67%

Aortic Pulse-Wave Velocity and Its Relationship to Mortality in Diabetes and Glucose Intolerance

et al. 2002

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“…Based on our observations, it is suggested that cigarette smoking induces endothelial dysfunction in young, healthy subjects, which is characterized by a reduction in FMD and is at least in part reflected by the PWV. The PWV has been established as a non-invasive measure of arterial stiffness and sclerosis (12)(13)(14). The ability of the brachial-ankle PWV to assess peripheral vascular endothelial function has been incompletely investigated.…”

Section: Discussionmentioning

confidence: 99%

Measurement of the Brachial-Ankle Pulse Wave Velocity and Flow-Mediated Dilatation in Young, Healthy Smokers

et al. 2007

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The brachial-ankle pulse wave velocity (PWV) is a quick test which adequately estimates arterial stiffness.Because flow-mediated dilatation (FMD) of the brachial artery assesses an essential endothelial function, we tested the hypothesis that the brachial-ankle PWV could reflect the early stages of endothelial dysfunction caused by smoking in young, healthy subjects. Fifty-seven healthy subjects (13 females and 44 males; mean 29.9±5.6 years) were enrolled. Twenty-six of the subjects (30.4 ± 5.7 years) were active smokers, with a mean cumulative nicotine consumption of 10.0 ± 8.6 pack/years, and thus were assigned to the smoking group. Thirty-one subjects without a history of smoking (29.5 ± 5.5 years) were assigned to the non-smoking group.The brachial-ankle PWV and arterial blood pressure were simultaneously measured using a recently established, non-invasive automatic device (model BP-203RPE; Nihon Colin, Tokyo, Japan). Endothelium-dependent FMD was induced by reactive hyperemia, while endothelium-independent vasodilation of the brachial artery was induced by administration of sublingual nitroglycerin spray. The FMD was lower in the smoking group than in the non-smoking group (p <0.05). There was no significant difference between the two groups with respect to the brachial-ankle PWV. In the non-smoking group, multiple stepwise regression analysis revealed that FMD was predicted by the systolic blood pressure (F =16.351). In the smoking group, statistical analysis revealed that FMD was independently predicted by either the brachial-ankle PWV (F =8.108) or the subject's age (F =4.381). Our results suggest that a reduction in FMD is closely associated with the early stages of endothelial dysfunction caused by cigarette smoking in young, healthy subjects, which is at least partly reflected by the PWV value. (Hypertens Res 2007; 30: 607-612)

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“…3,15,16 Changes in arterial stiffness have been observed even at an early stage of disease and in young nondiabetic adults with a family history of type II DM. The prevention of micro-and macroangiopathy requires tight blood glucose control.…”

Section: Discussionmentioning

confidence: 99%

Effects of coexisting hypertension and type II diabetes mellitus on arterial stiffness

et al. 2004

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The Pulse Wave Velocity as an Early Indicator of Atherosclerosis in Diabetic Subjects

Cited by 152 publications

References 13 publications

Aortic Pulse-Wave Velocity and Its Relationship to Mortality in Diabetes and Glucose Intolerance

Aortic Pulse-Wave Velocity and Its Relationship to Mortality in Diabetes and Glucose Intolerance

Measurement of the Brachial-Ankle Pulse Wave Velocity and Flow-Mediated Dilatation in Young, Healthy Smokers

Effects of coexisting hypertension and type II diabetes mellitus on arterial stiffness

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