Both hypertension and diabetes are powerful risk factors of cardiovascular disease, however, their contribution to arterial stiffness is different. This study was designed to compare different arterial stiffness parameters among hypertensive and type-2 diabetic patients in a community-based elderly cohort.
2,098 (aged 70.3 ± 5.6 years) participants were recruited till June 2017. All participants were divided into 4 groups: I. without hypertension and without diabetes (normal group), II. without hypertension and with diabetes (DM group), III. with hypertension and without diabetes(HTN group), and IV. with hypertension and with diabetes (DM+HTN group). Three arterial stiffness parameters were measured with validated devices, including carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), and pulse pressure amplification (PPA).
The body mass index (BMI) was significantly lower in normal group than in the other 3 groups (P < = 0.02). Mean age, current smoker rate, physical activity, and education level were similar among 4 groups (P> = 0.22). Spearman correlation analysis showed that arterial stiffness parameters significantly correlated with age, mean blood pressure and heart rate. Generalized linear model with Tukey adjustment was applied to pairwise compare arterial stiffness parameters. Potential confounders including age, gender, BMI, mean blood pressure, heart rate, LDL-C, and use of insulin were adjusted in the model. Compared with normal group, PWV in the other 3 groups were significantly higher (P < 0.01), and PWV in DM+HTN group was significantly higher than DM group and HTN group (P < 0.001). The AIx in DM group and in DM+HTN group were significantly lower than in normal group (P < 0.001), while AIx in HTN group and normal group were similar (P = 0.49). As for PPA, they did not differ between participants with diabetes and without diabetes (with/without hypertension, P = 0.99 and P = 0.12, respectively), while PPA in patients with hypertension were significantly higher than those without hypertension (P < 0.001).
In the community-based elderly cohort, PWV is associated with both DM and HTN. AIx is associated with DM but not HTN, and PPA is associated with HTN but not DM. This result may improve the cardiovascular risk assessment in the future.
1Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
2Paris Descartes University; AP-HP; Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France