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

Kunihiko Aizawa (Lead / Corresponding author), Phillip E. Gates, David M. Mawson, Francesco Casanova, Kim M. Gooding, Suzy V. Hope, Isabel Goncalves, Jan Nilsson, Faisel Khan, Helen M. Colhoun, Andrea Natali, Carlo Palombo, Angela C. Shore

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    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 (b 0) 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 0. In Phase 1, b 0 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 b 0 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 b 0 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 b 0. b 0 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 b 0 in people with type 2 diabetes (T2DM) compared to those without, and also a greater change in b 0 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.

    Original languageEnglish
    Pages (from-to)13-22
    Number of pages10
    JournalJournal of Applied Physiology
    Volume136
    Issue number1
    Early online date18 Dec 2023
    DOIs
    Publication statusPublished - 1 Jan 2024

    Keywords

    • aging
    • aorta
    • blood pressure
    • ultrasound

    ASJC Scopus subject areas

    • General Medicine

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