DIFFERENT IMPACT OF HYPERTENSION AND TYPE 2 DIABETES ON AORTIC, CAROTID AND PERIPHERAL VASCULAR STIFFNESS: PP.10.408

Abstract

Objective: Type-2 diabetes and hypertension both induce early vascular aging. Aim of the study is to explore the impact of diabetes, hypertension, and their combination on aortic, carotid and peripheral stiffening. Design and Method: 114 subjects (18 normotensives-NT, 37 hypertensives-HT, 20 diabetic normotensives-DMNT, and 39 diabetic hypertensives-DMHT) were enrolled. Applanation tonometry was used to measure aortic (carotid to femoral) and peripheral (carotid to radial) pulse wave velocity (aPWV and pPWV respectively). Common carotid intima-media thickness (IMT) and diameter were obtained by B-mode ultrasound image sequences, using the real-time computerized contour-tracking system “Carotid Studio”. Common carotid stiffness (CS) was determined from stroke change in lumen area and local pulse pressure obtained by applanation tonometry. Results: pPWV was superimposable in all groups. aPWV significantly increased ranging from NT (7.2 ± 1.0m/s) to HT (8.1 ± 1.4m/s) and DMNT (8.2 ± 0.8m/s), reaching the highest value in the DMHT group (10.6 ± 1.9m/s). CS behaved similarly (NT 6.0 ± 0.7m/s, DMNT 6.5 ± 1.2m/s, HT 6.6 ± 1.2m/s, DMHT 7.3 ± 1.2m/s). The presence of hypertension carried a 6.9-fold (confidence limits 5–95%: 1.9–24.8) increased risk of having an increased (above the median value) aPWV, a 2.8-fold (1.1–7.4) increased risk of having an increased CS, and a 3.9-fold (1.4–10.6) increased risk of having an increased carotid diameter, regardless of age and diabetes, while the analysis was not significant for pPWV and IMT. The presence of diabetes carried a 9.6-fold (3.3–27.2) increased risk of having an increased aPWV and a 2.7-fold (1.1–6.6) increased risk of having an increased IMT, regardless of age and hypertension, while the analysis was not significant for pPWV, carotid diameter and stiffness. Conclusions: Both diabetes and hypertension are associated with normal pPWV and increased aPWV, and their combination induces an even greater aortic stiffness. Hypertension is characterized by vascular stiffness at both the aortic and carotid level. In contrast, diabetes is associated only with increased aPWV. The two conditions are also different for carotid remodeling characteristics, since hypertension determines dilation while diabetes wall thickening.