Duration of diabetes mellitus is a significant predictor of arterial stiffness in patients with arterial hypertension and type 2 diabetes mellitus

Abstract

BackgroundDiabetic complications increase with disease duration but little is known about the relationships between aortic stiffness and diabetes duration.Aimto assess associations of diabetes mellitus (DM) duration and parameters of arterial stiffness in patients with arterial hypertension (AH) and T2DM.Methods90 patients with AH and T2DM were included (39%males, mean age63,8 ± 11,6 years, 44%smokers). Mean office BP was 146 ± 23/ 86 ± 10 mmHg. All patients received combined AHT, target BP < 140/ 85 mmHg was achieved in 52,7% of patients. Median duration of DM was 8,5 years (IQR 2; 13 years), mean glucose was 8,0 ± 2,4mmol/l, mean HbA1c 9,2 ± 2,0%. BP was measured with a validated oscillometric device. Parameters of arterial stiffness were assessed by applanation tonometry, cardio- ankle vascular index (CAVI) and vascular age were measured (VaSera 1500). p < 0,05 was considered significant.ResultsMean central BP was 132 ± 18/79 ± 12 mmHg, mean cfPWV–10,5 ± 2,4m/s, mean R- CAVI-8,8 ± 1,9, L-CAVI-8,9 ± 1,8. Further analysis was performed in subgroups according to tertiles of DM duration (G1 < 4 years (n = 31), G2–4-10 years (n = 30), G3 > 10 years (n = 29)). Patients in G3 were older (69,5 ± 11,1 vs 62,1 ± 11,2 vs 60,0 ± 10,8 years), had higher vascular age (73,8 ± 9,0 vs 68,6 ± 11,8 vs 64,5 ± 13,4 years) and R-CAVI (9,3 ± 1,9 vs 9,0 ± 1,8 vs 8,1 ± 1,9); p < 0,05 for trend. Patients from G3 and G2 had the highest level of cfPWV compared to G1 (11,0 ± 2,0 and 11,4 ± 2,4 vs 9,1 ± 2,4m/s, p = 0,0009). There were significant correlations between duration of DM and age (r = 0,35), vascular age (r = 0,30), creatinine (r = 0,23), cfPWV (r = 0,34), and R-CAVI (r = 0,3). Only age and DM duration were predictors of PWV increase (β = 0,3, p = 0,02 and b = 0,2, p = 0,04, respectively).ConclusionsIn diabetic patients, aortic stiffness is strictly correlated with diabetes duration, independently of blood pressure level and diabetes control.