Association between diabetes mellitus and central arterial stiffness in elderly patients with systemic arterial hypertension

ABSTRACT

Background

Aging increases the risk of chronic diseases, especially cardiovascular diseases, leading to changes in cardiovascular anatomy and physiology even in the absence of other comorbidities. Numerous cardiovascular risk factors (CVRFs), such as diabetes mellitus (DM) and systemic arterial hypertension (SAH), can modify the functional and structural properties of large vessels, increasing arterial stiffness.

Objective

To determine whether elderly patients with hypertension with DM have greater central arterial stiffness than elderly patients with SAH without DM.

Methods

The Study of Pulse Wave Velocity in the Elderly in an Urban Area in Brazil (EVOPIU) included 1,192 patients aged ≥ 60 years who underwent applanation tonometry (AT) to evaluate carotid-femoral pulse wave velocity (cfPWV). From this database, 1,133 patients were selected from 6 groups: NDN (nondiabetic normotensives; n: 127); DN (diabetic normotensives; n: 64); NDCH (nondiabetic controlled hypertensives; n: 168); DCH (diabetic controlled hypertensives; n: 275); NDH (nondiabetic hypertensives; n: 217) and DH (diabetic hypertensives; n: 282). All groups underwent AT to obtain cfPWV and central and peripheral arterial pressures.

Results

The pulse wave velocities found were as follows: NDN vs DN (8.9 ± 0.2 m/s vs 9.4 ± 0.2; P = .103); NDCH vs DCH (9.0 ± 0.2 m/s vs. 9.6 ± 0.1 m/s; P= .04) and NDH vs DH (9.2 ± 0.1 m/s vs. 9.6 ± 0.1 m/s; P= .045). When the diabetic groups were compared, there were no differences in cfPWV values, and the same occurred when the nondiabetic groups were compared.

Conclusions

Elderly patients with diabetes and hypertension have greater central arterial stiffness than patients without diabetes and hypertension, regardless of systemic blood pressure control. The central arterial stiffness caused by vascular aging seems to be a common factor among all the studied groups.

KEYWORDS:

• Elderly
• arterial stiffness
• hypertension
• diabetes mellitus

Authors’ contributions

All authors are responsible for designing the study, writing the manuscript and approving the final version to be published.

Ethics statement

This study was approved by the Research Ethics Committee of Federal University of Uberlândia (CAAE n. 37440114.3.0000.5152), and the participants signed an informed consent form.

Acknowledgments

Research Support Foundation of Minas Gerais (Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG)

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG.