Aortic stiffness and cardiovascular risk in type 2 diabetes.

OBJECTIVE: Damage to large arteries is a major contributor to high cardiovascular morbi-mortality in type 2 diabetic patients. Pulse wave velocity (PWV), depending on both structural and functional characteristics of the arterial wall, has poorly been ascertained in its ability to be a marker of cardiovascular risk in diabetic patients. In order to determine the factors influencing aortic stiffness, and the potential predictor role of this measurement, a cross-sectional study on a cohort of 618 type 2 diabetic patients with or without cardiovascular events was conducted.
METHODS: Aortic PWV (estimated by carotid-femoral PWV measurement) was determined using an automatic device and cardiovascular risk was determined, using Framingham equation (10-year absolute cardiovascular disease risk), in individuals without previous cardiovascular events. Multilinear regression analysis was performed to assess relationships between aortic PWV, population characteristics and the presence of cardiovascular disease. Multivariate models (with and without PWV) were compared to determine whether aortic PWV improves explicative model of presence of cardiovascular disease.
RESULTS: Increased aortic PWV was strongly associated with presence of coronary, cerebral and peripheral vascular diseases. Increased aortic PWV was independently associated with previous cardiovascular events and improved the explicative model of presence of cardiovascular disease above the known cardiovascular risk factors.
CONCLUSION: This study provides evidence that aortic PWV is a forceful independent marker of cardiovascular disease in diabetic patients, as it has already been demonstrated in hypertensive individuals. Prospective trials are needed to assess the improvement in cardiovascular risk prediction for widespread use of aortic PWV in diabetic patients.