Comparison Of Arterial Stiffness Parameters In Hypertensive And Type-2 Diabetic Patients: The Northern Shanghai Study

Objectives: To compare different arterial stiffness parameters among hypertensive and type-2 diabetic patients in a community-based elderly cohort. Methods: 2,098 (aged 70.3 ± 5.6 years) participants were recruited till June 2017. Participants were divided into 4 groups: ¢Ùwithout hypertension without diabetes (normal group), ¢Úwithout hypertension with diabetes (DM group), ¢ûwith hypertension without diabetes (HTN group), and ¢Üwith hypertension with diabetes (DM + HTN group). Three arterial stiffness parameters were measured with validated devices, including carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), and pulse pressure amplification (PPA). Results: Correlation analysis showed that arterial stiffness parameters significantly correlated with age, mean blood pressure and heart rate. Generalized linear model with Tukey adjustment was applied to pairwise compare arterial stiffness parameters. Potential confounders including age, gender, BMI, mean blood pressure, heart rate, LDL-C, and use of insulin were adjusted. Compared with normal group, PWV in the other 3 groups were significantly higher (P < 0.01), and PWV in DM + HTN group was significantly higher than DM group and HTN group (P < 0.001). The AIx in DM group and in DM + HTN group were significantly lower than in normal group (P < 0.001), while AIx in HTN group and normal group were similar (P = 0.49). As for PPA, they did not differ between participants with diabetes and without diabetes (with/without hypertension, P = 0.99 and P = 0.12, respectively), while PPA in patients with hypertension were significantly higher than those without hypertension (P < 0.001). Conclusion: PWV is associated with both DM and HTN. AIx is associated with DM but not HTN, and PPA is associated with HTN but not DM. This result may improve the cardiovascular risk assessment.