Abstract
Background: Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in Western societies and are rapidly becoming a worldwide health problem. African-Americans have increased morbidity and mortality rates from CVD. Our study aimed to assess the effects of the CVD risk factors burden alone versus with diabetes mellitus in a high riskCVDpopulation. Methods: The two study groups consisted of thirty seven diabetics and thirty seven non-diabetic African-Americans aged ≥55 years without clinical atherosclerosis having similar cardiovascular risk factors (age, hypertension, hypercholesterolemia, smoking, and body mass index) except for diabetes mellitus. Brachial artery flow-mediated dilation (FMD), Nitroglycerin-mediated dilatation (NMD) and carotid intima-media thickness (IMT) were recorded in all subjects. Results: Endothelial function as assessed by the brachial artery FMD was significantly impaired in the diabetic group compared to the non-diabetic group (7.8 ± 5 vs 3.3 ± 4; p = 0.0001). There were no differences in neither Nitroglycerin-mediated dilatation (NMD) nor carotid intima-media thickness (IMT) in the diabetic and non-diabetic groups. Conclusion: The contribution of diabetes to the development of endothelial dysfunction in subjects with clustering of CVD risk factors may be early as indicated by significant functional changes preceeding structural vascular changes..
Highlights
Type 2 diabetes mellitus (DM) has reached epidemic levels with an adult world prevalence estimated to be at 366 million in 2011, and with an expected increase to 552 million by 2030 [1].These alarming predictions indicate a growing economic burden among patients and society more broadly
The two study groups consisted of thirty seven diabetics and thirty seven non-diabetic African-Americans aged ≥55 years without clinical atherosclerosis having similar cardiovascular risk factors except for diabetes mellitus
With this goal in mind, we studied 2 groups of patients without clinical atherosclerosis having similar cardiovascular risk factors except for diabetes mellitus
Summary
Type 2 diabetes mellitus (DM) has reached epidemic levels with an adult world prevalence estimated to be at 366 million in 2011, and with an expected increase to 552 million by 2030 [1] These alarming predictions indicate a growing economic burden among patients and society more broadly. The main aim of this study was to investigate the impact of DM on vascular structure and function as reflected by carotid intima-media thickness (IMT), brachial artery flow mediated dilatation (FMD) respectively. With this goal in mind, we studied 2 groups of patients without clinical atherosclerosis having similar cardiovascular risk factors (age, hypertension, hypercholesterolemia, smoking, and body mass index) except for diabetes mellitus. Conclusion: The contribution of diabetes to the development of endothelial dysfunction in subjects with clustering of CVD risk factors may be early as indicated by significant functional changes preceeding structural vascular changes
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