4.1 Pulse Wave Velocity Changes Over a Four Years Follow up: Synergic Effects of Diabetes and Hypertension

• Published in: Artery research Vol. 6; no. 4; p. 147
• Main Authors: Cesana, C. F., Meani, M. P., Castagna, C. F., Giupponi, G. L., Soffici, S. F., Nava, N. S., Varrenti, V. M., Ribecca, R. D., Baroni, B. M., Stucchi, S. M., Facchetti, F. R., Moreo, M. A., Giannattasio, G. C., Mancia, M. G.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 2012; Springer Nature B.V; BMC
• Subjects: Age; Conference Abstract; Creatinine; Diabetes; Hypertension
• DOI: 10.1016/j.artres.2012.09.025
• EISSN: 1876-4401
• ISSN: 1872-9312; 1876-4401

Objective
the presence of diabetes mellitus puts hypertensive patients in high cardiovascular risk class. Diabetics patients have higher arterial stiffness but scanty data are available on its changes over time. Aim of this study was to provide information about the time course of PWV alterations in treated hypertensives and diabetics during 4 years-follow up.
Design and Method
We enrolled 348 treated hypertensive patients, among them 38 were diabetics (HTD, 61±11yrs, mean±SD) while others were only hypertensives (HT, 54±13yrs,). At baseline (t0), we collected for all of them clinical history, anthropometric parameters, clinic blood pressure (BP), cf-PWV (Complior), IMT and creatinine levels. Four years later (t1), we reassessed cf-PWV.
Results
After adjusting for age we didn’t find statistical differences between HTD and HT at T0 for: BP(146.5±16/85±11 vs 140.5±19/ 86±10mmHg), creatinine (0,85±0, 15vs0.86±0, 19mg/dL), IMT (0,68±0, 17vs0,65±0,18mm) and PWV (11,6±2,4vs10.6±2,4m/s). Interestingly, HTD increased their PWV significantly more than HT in 4 years (t1PWV-t0PWV = 2,36±4,4m/s vs 0,71±2,8m/s, P adjusted for age = 0,0099). Moreover, at a multivariate analysis, diabetes, age and baseline PWV were independent predictors of PWV increase, while baseline PWV was predictive of PWV decrease in four years (r2 (PWV+age+diabetes) = 0.3040, t0PWV beta:-0.65, P<0.0001; age beta: 0.074, P<0.0001; diabetes beta 1,044, P = 0,0332).
Conclusions
During 4 years in a popolutation of treated hypertensive, diabetics showed an higher increase in PWV’s values this change being influenced by age and diabetes presence. Our data confirm the synergism between hypertension, diabetes and aging in inducing and increase of arterial stiffness along the time.
Funding
EU-MASCARA project -FP7/2007-2013 .