Higher blood pressure increases arterial stiffness modified by blood glucose levels in a Chinese community-based study

Abstract

Background:

Increased arterial stiffness measured by brachial-ankle pulse wave velocity is associated with cardiovascular disease. However, the rates at which brachial-ankle pulse wave velocity and blood glucose accelerate within individuals who differ in blood pressure levels are largely unknown.

Methods:

This study was based on the baseline data of a Chinese community-based atherosclerosis cohort which included 7402 individuals. Using generalized linear regression models, the relationship between blood glucose levels and brachial-ankle pulse wave velocity, and the relationship between blood pressure levels and brachial-ankle pulse wave velocity were examined.

Results:

A marked interaction between hypertensive state and diabetic state was seen for brachial-ankle pulse wave velocity (P for interaction <0.001). The adjusted coefficient for subjects stratified by hypertensive groups and diabetic states showed that the highest brachial-ankle pulse wave velocity risk subjects were those who had both diabetes and hypertension (B=403.24; 95% CI: 372.43–434.05; P<0.001).

Conclusions:

The participants with increased arterial stiffness demonstrate a high prevalence of higher blood pressure. When high blood glucose levels co-occur with high blood pressure levels, there is a remarkable increase in arterial stiffness.

Keywords:

• communities
• diabetes
• hypertension

Acknowledgments

We really appreciate the staff of Gucheng and Pingguoyuan Community Health Centers and their research coordinators who participated in this survey and thank them for their assistance in data acquisition.

The study was supported by grants from the National Natural Science Foundation of China (81172768, 81872692), Beijing Municipal Natural Science Foundation (7182085) and the UM-PUHSC Joint Institute for Translational and Clinical Research (BMU20110177).

Abbreviation list

baPWV, brachial-ankle pulse wave velocity; T2DM, diabetes mellitus type 2; BP, blood pressure; ABI, ankle-brachial index; PWV, pulse wave velocity; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBG, fasting blood glucose; 2-h PG, 2-hr post-load glucose; BMI, Body mass index; DM, diabetes mellitus; TC, total cholesterol; HDL-C/HDL, high-density lipoprotein cholesterol; TG, total triglycerides; WHR, waist-to-hip ratio; AGEs, advanced glycation end products; PP, pulse pressure.

Ethics approval and consent to participate

The study protocol was approved by the ethics committee of Peking University First Hospital. The research was conducted according to the World Medical Association Declaration of Helsinki. The adolescents who participated in this study agreed in writing to participate and their legal guardians signed an informed consent form.

Availability of data and materials

The data that support the findings of this study are available from Peking University First Hospital, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Peking University First Hospital.

Supplementary materials

Table S1 The effect of blood pressure levels, blood glucose levels on the risk of baPWV

Table S2 The effect of blood glucose levels on the risk of baPWV by different blood pressure level

Table S3 Interaction of blood pressure levels, blood glucose levels on baPWV

Table S4 Interaction of physical exercise and the combined variable of blood pressure levels and blood glucose levels on baPWV

Author contributions

X Dai wrote the manuscript. Z Liu performed the statistical analyses. D Chen and Y Zhang revised the paper. All authors contributed towards data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.