BACKGROUND: Pulse pressure (PP) increases with age as a result of arterial stiffening and is a powerful predictor of cardiovascular disease. Type 1 diabetes is associated with excessive cardiovascular mortality and increased arterial stiffness. We examined whether the age-related blood pressure changes in type 1 diabetic patients differ from those of the nondiabetic METHODS AND RESULTS: We performed a cross-sectional, case-control study of 2988 consecutively selected diabetic subjects and 5486 randomly selected nondiabetic control subjects. Blood pressure was measured twice by mercury sphygmomanometry on a single occasion. Compared with controls, diabetic subjects had a higher systolic blood pressure in all age groups, whereas diastolic blood pressure was higher in those <40 years but lower in those >45 years of age. Consequently, diabetic subjects had a higher PP and a higher prevalence of isolated systolic hypertension. The early age-related rise in PP was more pronounced in subjects with diabetic nephropathy but was also evident in diabetic subjects with normal albumin excretion rate. In a multiple regression analysis, PP in diabetic patients was associated with age, male sex, duration of diabetes, and albuminuria. CONCLUSIONS: A higher systolic pressure and an earlier decrease in diastolic pressure result in a higher and more rapidly increasing PP in type 1 diabetic patients. Our findings indicate accelerated arterial aging, which may contribute to the higher cardiovascular morbidity and mortality in these patients.
BACKGROUND: Pulse pressure (PP) increases with age as a result of arterial stiffening and is a powerful predictor of cardiovascular disease. Type 1 diabetes is associated with excessive cardiovascular mortality and increased arterial stiffness. We examined whether the age-related blood pressure changes in type 1 diabeticpatients differ from those of the nondiabetic METHODS AND RESULTS: We performed a cross-sectional, case-control study of 2988 consecutively selected diabetic subjects and 5486 randomly selected nondiabetic control subjects. Blood pressure was measured twice by mercury sphygmomanometry on a single occasion. Compared with controls, diabetic subjects had a higher systolic blood pressure in all age groups, whereas diastolic blood pressure was higher in those <40 years but lower in those >45 years of age. Consequently, diabetic subjects had a higher PP and a higher prevalence of isolated systolic hypertension. The early age-related rise in PP was more pronounced in subjects with diabetic nephropathy but was also evident in diabetic subjects with normal albumin excretion rate. In a multiple regression analysis, PP in diabeticpatients was associated with age, male sex, duration of diabetes, and albuminuria. CONCLUSIONS: A higher systolic pressure and an earlier decrease in diastolic pressure result in a higher and more rapidly increasing PP in type 1 diabeticpatients. Our findings indicate accelerated arterial aging, which may contribute to the higher cardiovascular morbidity and mortality in these patients.
Authors: Li Li; David J Ruau; Chirag J Patel; Susan C Weber; Rong Chen; Nicholas P Tatonetti; Joel T Dudley; Atul J Butte Journal: Sci Transl Med Date: 2014-04-30 Impact factor: 17.956
Authors: Ville-Petteri Mäkinen; Carol Forsblom; Lena M Thorn; Johan Wadén; Kimmo Kaski; Mika Ala-Korpela; Per-Henrik Groop Journal: Cardiovasc Diabetol Date: 2009-10-06 Impact factor: 9.951
Authors: Catherine T Prince; Aaron M Secrest; Rachel H Mackey; Vincent C Arena; Lawrence A Kingsley; Trevor J Orchard Journal: Diabetes Care Date: 2009-12-29 Impact factor: 17.152