Increased pulse wave velocity is not associated with... : Journal of Hypertension (original) (raw)

ORIGINAL PAPERS: BLOOD VESSELS

Increased pulse wave velocity is not associated with elevated augmentation index in patients with diabetes

Lacy, Peter S; O'Brien, David G; Stanley, Adrian G; Dewar, Mairead M; Swales, Philip PR; Williams, Bryan

Department of Cardiovascular Sciences, Cardiovascular Research Institute, University of Leicester, Leicester LE2 7LX, UK.

*Joint first authors.

Sponsorship: This work was supported by a grant from the National Health Service Research and Development.

Correspondence to Bryan Williams, Department of Cardiovascular Sciences, Cardiovascular Research Institute, University of Leicester, Leicester. LE2 7LX, UK. Tel: +44 116 2523182; fax: +44 1162525847; e-mail: [email protected]

Requests for reprints to Peter Lacy, Department of Cardiovascular Sciences, Cardiovascular Research Institute, University of Leicester, Leicester. LE2 7LX, UK. Tel: +44 116 2523255 fax: +44 1162525847; e-mail: [email protected]

Received 23 January 2004 Revised 16 April 2004 Accepted 1 June 2004

See editorial commentary on page 1863

Abstract

Objective

Increased arterial stiffness is a risk factor for cardiovascular disease and is a feature associated with diabetes. Pulse wave velocity (PWV) is an accepted index of arterial stiffness and augmentation index (AI) derived from radial applanation tonometry has been advocated as a measurement of arterial stiffness. This study compares the relationship between PWV and AI in people with and without diabetes.

Design and methods

A total of 66 people with diabetes and 66 age-matched non-diabetic controls were studied. Central aortic pressure waves were generated using applanation tonometry over the radial artery and used to calculate AI. Carotid–femoral PWV (PWVcf) was measured simultaneously.

Results

Relative to controls, diabetes was associated with increased pulse pressure (PP) and PWVcf (P < 0.01). In contrast, AI did not differ between groups even after adjustment for heart rate. This observation remained consistent irrespective of diabetes type, arterial site, and the presence or absence of antihypertensive therapy. Multiple regression analysis revealed diabetes to be a significant determinant of PWVcf, but not AI.

Conclusions

PP and PWVcf are increased in people with diabetes, but this is not associated with increased AI. These findings conclusively demonstrate that AI is not a reliable measure of arterial stiffness in people with diabetes.