ARTERIAL STIFFNESS IN PREHYPERTENSIVE PATIENTS WITH PREDIABETES - A PILOT STUDY

Abstract

Objective: Prediabetes is associated with higher cardiovascular risk and increased all-cause mortality in the general population. The aim of this study was to determine whether there are differences in primary laboratory findings and pulse wave velocity (PWV) between prehypertensive patients with and without prediabetes. Design and method: This study included 58 patients (39 women, 19 men) with prehypertension according to the JNC7 criteria from 2003 (systolic blood pressure [SBP] 120-139mmHg or diastolic blood pressure [DBP] 80-89mmHg based on 2 or more seated measurements on each of 2 or more office visits) from one family practice in Health center Zagreb-west. Patients were divided into two groups depending on having prediabetes (fasting plasma glucose [FPG] 5.6-6.9 mmol/L – according to American Diabetic Association (ADA) criteria from 2014). Basic laboratory tests (cholesterol, creatinine, fasting glucose, and potassium), anthropometric, 24h ambulatory blood pressure, and pulse wave velocity (PWV) measurements (with Agedio B900) were done in all patients. Renal function was calculated with the CKD-EPI formula (KDIGO 2020). Mann-Whitney U test, multiple linear regression model, and descriptive statistics were used in data processing in Statistica v.12.0. Results: Normal FPG was found in 41 patients (70.7%), while 17 patients had prediabetes (29.3%). Prehypertensive patients with prediabetes were older (median 58 vs. 54 years; p<0.01), had significantly higher uric acid concentration (median 324 vs 282 mmol/L; p<0.05), and higher PWV (median 8.20 vs. 7.45m/s; p<0.01). No differences were found in the concentration of potassium, LDL cholesterol, triglycerides, and body mass index (median 24kg/m2). FBG levels were independently and significantly associated with PWV (beta = 0.33; p<0.05). Conclusions: This pilot study indicates the possible existence of accelerated atherosclerosis in prehypertensive individuals with prediabetes compared to those with normal FPG. Research on a larger sample is needed to confirm these findings.