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Type 2 diabetes exacerbates changes in blood pressure-independent arterial stiffness : cross-sectional and longitudinal evidence from the SUMMIT study

Aizawa, Kunihiko ; Gates, Phillip E. ; Mawson, David M. ; Casanova, Francesco ; Gooding, Kim M. ; Hope, Suzy V. ; Goncalves, Isabel LU orcid ; Nilsson, Jan LU ; Khan, Faisel and Colhoun, Helen M. , et al. (2024) In Journal of Applied Physiology 136(1). p.13-22
Abstract

Greater central artery stiffness is observed in people with type 2 diabetes (T2DM). Elevated blood pressure (BP) and altered arterial wall structure/composition in T2DM are generally considered as main drivers for this alteration. However, because conventional arterial stiffness measures are BP-dependent and as such an influence of BP remains in a measure, it is unclear if greater central artery stiffness is a function of greater BP, or due to changes in the structure and composition of the arterial wall. We aimed to measure BP-independent arterial stiffness (b0) cross-sectionally and longitudinally in T2DM. We studied 753 adults with T2DM (DM þ) and 436 adults without (DM-) at baseline (Phase 1), and 310 DM þ and 210 DM-... (More)

Greater central artery stiffness is observed in people with type 2 diabetes (T2DM). Elevated blood pressure (BP) and altered arterial wall structure/composition in T2DM are generally considered as main drivers for this alteration. However, because conventional arterial stiffness measures are BP-dependent and as such an influence of BP remains in a measure, it is unclear if greater central artery stiffness is a function of greater BP, or due to changes in the structure and composition of the arterial wall. We aimed to measure BP-independent arterial stiffness (b0) cross-sectionally and longitudinally in T2DM. We studied 753 adults with T2DM (DM þ) and 436 adults without (DM-) at baseline (Phase 1), and 310 DM þ and 210 DM- adults at 3-yr follow-up (Phase 2). We measured carotid-femoral pulse wave velocity and used it to calculate b0. In Phase 1, b0 was significantly greater in DM þ than DM- after adjusting for age and sex [27.5 (26.6–28.3) vs. 23.6 (22.4–24.8) au, P < 0.001]. Partial correlation analyses after controlling for age and sex showed that b0 was significantly associated with hemoglobin A1c (r ¼ 0.15 P < 0.001) and heart rate [(HR): r ¼ 0.23 P < 0.001)] in DM þ . In Phase 2, percentage-change in b0 was significantly greater in DM þ than DM-[19.5 (14.9–24.0) vs. 5.0 (-0.6 to 10.6) %, P < 0.001] after adjusting for age, sex, and baseline b0. b0 was greater in DM þ than DM- and increased much more in DM þ than in DM- over 3 yr. This suggests that T2DM exacerbates BP-independent arterial stiffness and may have a complemental utility to existing arterial stiffness indices. NEW & NOTEWORTHY We demonstrate in this study a greater BP-independent arterial stiffness b0 in people with type 2 diabetes (T2DM) compared to those without, and also a greater change in b0 over 3 yr in people with T2DM than those without. These findings suggest that the intrinsic properties of the arterial wall may change in a different and more detrimental way in people with T2DM and likely represents accumulation of cardiovascular risk.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
aging, aorta, blood pressure, ultrasound
in
Journal of Applied Physiology
volume
136
issue
1
pages
10 pages
publisher
American Physiological Society
external identifiers
  • pmid:37969084
  • scopus:85180371426
ISSN
8750-7587
DOI
10.1152/japplphysiol.00283.2023
language
English
LU publication?
yes
id
648d9ebf-4709-4ec9-908c-5ce619d2772e
date added to LUP
2024-01-31 11:23:37
date last changed
2024-04-16 23:38:54
@article{648d9ebf-4709-4ec9-908c-5ce619d2772e,
  abstract     = {{<p>Greater central artery stiffness is observed in people with type 2 diabetes (T2DM). Elevated blood pressure (BP) and altered arterial wall structure/composition in T2DM are generally considered as main drivers for this alteration. However, because conventional arterial stiffness measures are BP-dependent and as such an influence of BP remains in a measure, it is unclear if greater central artery stiffness is a function of greater BP, or due to changes in the structure and composition of the arterial wall. We aimed to measure BP-independent arterial stiffness (b<sub>0</sub>) cross-sectionally and longitudinally in T2DM. We studied 753 adults with T2DM (DM þ) and 436 adults without (DM-) at baseline (Phase 1), and 310 DM þ and 210 DM- adults at 3-yr follow-up (Phase 2). We measured carotid-femoral pulse wave velocity and used it to calculate b<sub>0</sub>. In Phase 1, b<sub>0</sub> was significantly greater in DM þ than DM- after adjusting for age and sex [27.5 (26.6–28.3) vs. 23.6 (22.4–24.8) au, P &lt; 0.001]. Partial correlation analyses after controlling for age and sex showed that b<sub>0</sub> was significantly associated with hemoglobin A1c (r ¼ 0.15 P &lt; 0.001) and heart rate [(HR): r ¼ 0.23 P &lt; 0.001)] in DM þ . In Phase 2, percentage-change in b<sub>0</sub> was significantly greater in DM þ than DM-[19.5 (14.9–24.0) vs. 5.0 (-0.6 to 10.6) %, P &lt; 0.001] after adjusting for age, sex, and baseline b<sub>0</sub>. b<sub>0</sub> was greater in DM þ than DM- and increased much more in DM þ than in DM- over 3 yr. This suggests that T2DM exacerbates BP-independent arterial stiffness and may have a complemental utility to existing arterial stiffness indices. NEW &amp; NOTEWORTHY We demonstrate in this study a greater BP-independent arterial stiffness b<sub>0</sub> in people with type 2 diabetes (T2DM) compared to those without, and also a greater change in b<sub>0</sub> over 3 yr in people with T2DM than those without. These findings suggest that the intrinsic properties of the arterial wall may change in a different and more detrimental way in people with T2DM and likely represents accumulation of cardiovascular risk.</p>}},
  author       = {{Aizawa, Kunihiko and Gates, Phillip E. and Mawson, David M. and Casanova, Francesco and Gooding, Kim M. and Hope, Suzy V. and Goncalves, Isabel and Nilsson, Jan and Khan, Faisel and Colhoun, Helen M. and Natali, Andrea and Palombo, Carlo and Shore, Angela C.}},
  issn         = {{8750-7587}},
  keywords     = {{aging; aorta; blood pressure; ultrasound}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{13--22}},
  publisher    = {{American Physiological Society}},
  series       = {{Journal of Applied Physiology}},
  title        = {{Type 2 diabetes exacerbates changes in blood pressure-independent arterial stiffness : cross-sectional and longitudinal evidence from the SUMMIT study}},
  url          = {{http://dx.doi.org/10.1152/japplphysiol.00283.2023}},
  doi          = {{10.1152/japplphysiol.00283.2023}},
  volume       = {{136}},
  year         = {{2024}},
}