Abstract 17467: Early Vascular Aging Predicts the Incidence of Diabetes in Hypertensives

Abstract

Introduction: Diabetes is associated with vascular aging. Arterial stiffness, a marker of vascular aging, is an independent predictor of cardiovascular events and mortality. However, the role of arterial stiffness in the incidence of diabetes has not been investigated. Hypothesis: We sought to investigate the role of carotid-femoral pulse wave velocity (PWV) in the prediction of incident diabetes in hypertensives and hypertensives under treatment with statins. Methods: 376 never-treated hypertensives (mean age 53±13 years, 175 females) without a known history of diabetes or cardiovascular disease at baseline, were included in the study. Markers of target organ damage [carotid-femoral PWV, aortic augmentation index corrected for heart rate (AIx@75) and estimated glomerular filtration rate (eGFR)] were evaluated at baseline in all patients. eGFR was estimated using the Cockcroft-Gault formula. Hemoglobin A1c (HbA1c) and blood glucose were measured in venous blood samples. Patients were followed-up prospectively for the incidence of diabetes as defined by the American Diabetes Association criteria. 139 patients received statins during follow-up. Results: During a median of 13.6 years follow-up, 55 patients (13.4%) patients were diagnosed with diabetes. In multivariable logistic regression analysis, higher PWV (Odds Ratio [OR] = 1.29, 95% Confidence intervals [CI]: 1.02-1.63, P = 0.034) was associated with a higher risk of incident diabetes, which was independent of relevant confounders. In further analysis, receiver operating characteristic (ROC) curves were generated to evaluate the ability of PWV to discriminate subjects with diabetes. The area under the curve (AUC) and 95% CIs of the ROC curve was AUC=0.67 (95% CI: 0.59-0.74, P<0.001) for PWV. In the subgroup of patients under treatment with statins, higher PWV (OR = 1.69, 95% CI: 1.19-2.40, P = 0.004) was also independently associated with a higher risk of incident diabetes. AIx@75 was not associated with the incidence of diabetes. Conclusions: Higher arterial stiffness, a marker of early vascular aging, is associated with the incidence of diabetes and also can identify subjects under treatment with statins that are more likely to present with diabetes in the future.