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The role of type 2 diabetes mellitus on hypertensive‐related aortic stiffness
Author(s) -
Sciatti Edoardo,
Vizzardi Enrico,
Castiello Assunta,
Valentini Francesca,
Bonadei Ivano,
Gelsomino Sandro,
Lorusso Roberto,
Metra Marco
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13841
Subject(s) - medicine , cardiology , type 2 diabetes mellitus , diabetes mellitus , pulse wave velocity , dyslipidemia , body mass index , arterial stiffness , blood pressure , pulse pressure , confounding , disease , endocrinology
Background Hypertension is strongly related to arterial stiffness in a cause‐effect fashion. Diabetes mellitus is also thought to determine vascular damage, mostly by means of advanced glycosylation end‐products (AGEs). Aim of our study was to study the role of type 2 diabetes mellitus (T2DM) as regard ascending aortic elastic properties in hypertensive patients. Methods We prospectively enrolled outpatients with hypertension (n = 99) and type 2 diabetes mellitus plus hypertension (n = 42) without cardiovascular events. They underwent a transthoracic echocardiography to measure aortic diameters, aortic elastic properties (ie, compliance, distensibility, stiffness index, Peterson's elastic modulus, pulse wave velocity, M‐mode strain), tissue Doppler imaging (TDI) to calculate diastolic (Eʹ and Aʹ) and systolic (Sʹ) velocities, and tissue strain. Multivariable analysis was run to assess the association between T2DM and these variables after correcting for possible confounders (age, sex, body mass index [BMI], dyslipidemia). Results The two groups did not differ as regards age, sex, BMI, and blood pressure. However, T2DM patients were more likely to be dyslipidemic (43% vs 71%, P = .003). Aortic diameters were similar in the two groups, but the aortic elastic properties significantly more impaired in T2DM group. At multivariable analysis, stiffness index, Peterson's elastic modulus, the TDI waves, and the tissue strain remained associated with the co‐presence of T2DM and hypertension. Conclusion Our data suggest that people suffering from both T2DM and hypertension have more impaired aortic elastic properties than those hypertensive alone. Considering the prognostic role of aortic stiffness, these patients may benefit from a closer follow‐up.