Vascular risk factors in women with hypertension and diabetes mellitus type 2 (original) (raw)
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Vascular risk factors in women with hypertension and diabetes mellitus type 2 1 ADRIANA ALBU , 1
2010
Background. Diabetes mellitus and arterial hypertension are two very frequent diseases. Both of them have important effects on vascular system and their major complications are caused by alterations of vasculature. Arterial hypertension and type 2 diabetes are frequently associated. Beyond classical risk factors implicated in both diseases, in recent years some novel markers of vascular involvement have been studied, such as intima – media thickness (IMT) and parameters of arterial stiffness. Women seem to have an increased vascular risk associated with diabetes than do men but this is not clean from the current literature. The aim of our study was to determine the consequences of hypertension and of hypertension associated with diabetes on intima media thickness and arterial stiffness in women. Patients and methods. We studied 30 women with hypertension (group 1), 33 with diabetes mellitus and hypertension (group 2) and 21 healthy controls (HC), matched for age. We evaluated some c...
Markers of increased vascular risk in women with hypertension and type 2 diabetes mellitus
Background. Diabetes mellitus and arterial hypertension have important effects on vascular system and their major complications are caused by alterations of vasculature. These diseases are frequently associated. Beyond classical risk factors implicated in both diseases, in recent years some novel markers of vascular involvement have been studied, such as intima – media thickness (IMT) and parameters of arterial stiffness. Women seem to have an increased vascular risk associated with diabetes than do men. The aim of our study was to determine the consequences of hypertension associated with diabetes on intima media thickness and arterial stiffness in women. Patients and methods. We studied 54 women, 33 with diabetes mellitus and hypertension and 21 healthy controls (HC), matched for age. We evaluated classical risk factors for atherosclerosis, such as age, body mass index, smoking, lipid and glucose profile. We determined IMT of the carotid artery using an ultrasound device (ALOKA Pr...
Hypertension, Diabetes Type II, and Their Association: Role of Arterial Stiffness
American journal of hypertension, 2015
In patients with both hypertension and type II diabetes, the systolic blood pressure (SBP) increases linearly with age, while that of diastolic blood pressure (DBP) declines curvilinearly as early as age 45, all suggesting the development of increased arterial stiffness. Increased stiffness is an important, independent, and significant risk predictor in subjects with hypertension and diabetes. In patients with both diseases, stiffness assessed at the same mean arterial pressure (MAP) was significantly higher in diabetic patients. Arterial stiffness is related to age, heart rate (HR), and MAP, but in diabetic patients, it also related to diabetes duration and insulin treatment (IT). In the metabolic syndrome (MetSyn), diabetes also acts on the small arteries through capillary rarefaction to reduce the effective length of the arterial tree, increases the reflected pulse wave and thus the pulse pressure (PP). These studies indicate that diabetes and hypertension additively contribute t...
Diabetologia, 2012
Aims/hypothesis Endothelium-derived factors are thought to be physiological modulators of large artery stiffness. The aim of the study was to investigate whether endothelial function could be a determinant of arterial stiffness in essential hypertensive patients, in relation with the concomitant presence of type 2 diabetes mellitus. Methods The study included 341 participants (84 hypertensive patients with and 175 without type 2 diabetes mellitus, 82 matched controls). Brachial artery endotheliumdependent flow-mediated dilation (FMD) was determined by high-resolution ultrasound and computerised edge detection system. Applanation tonometry was used to measure carotid-femoral pulse wave velocity (PWV). Results Hypertensive patients with diabetes had higher PWV (10.1±2.3 m/s vs 8.6±1.4 m/s, p<0.001) and lower FMD (3.51±2.07 vs 5.16±2.96%, p<0.001) than non-diabetic hypertensive patients, who showed impaired vascular function when compared with healthy participants (7.9±1.6 m/s and 6.68 ± 3.67%). FMD was significantly and negatively correlated to PWV only in hypertensive diabetic patients (r0−0.456, p<0.001), but not in hypertensive normoglycaemic patients (r0−0.088, p00.248) or in healthy participants (r 00.008, p 00.946). Multivariate analysis demonstrated that, in the diabetic group, FMD remained an independent predictor of PWV after adjustment for confounders (r 2 00.083, p 00.003). Subgroup analysis performed in non-diabetic hypertensive patients revealed that neither obesity nor the metabolic syndrome affected the relationship between FMD and PWV. Conclusions/interpretation Endothelial dysfunction is a determinant of aortic stiffness in hypertensive diabetic patients but not in hypertensive patients without diabetes. These results suggest that type 2 diabetes mellitus on top of hypertension might worsen arterial compliance by endothelium-related mechanisms.
Diabetologia, 2005
Aims/hypothesis: Type 2 diabetes is associated with a two-to seven-fold increase in cardiovascular morbidity and mortality. The aim of this study was to determine the relationships between intima-media thickness (IMT), an established marker of atherosclerosis, large artery function and other determinants of cardiovascular risk in type 2 diabetic patients. Methods: We studied 228 type 2 diabetic patients (75 women, aged 62±2 years [mean± SEM]). Carotid IMT was bilaterally measured using ultrasound technology. Applanation tonometry and pulse wave analysis were used to measure aortic systolic and diastolic blood pressures, central pressure augmentation (AG) and the augmentation index (AIx), a measure of systemic arterial stiffness. Conventional cardiovascular risk factors (lipids, HbA 1 c, smoking and diabetes duration) were also assessed. Results: Women had higher AG and AIx (p<0.0001), despite comparable systolic BP and heart rate in women and men. In women, AG (r=0.39, p<0.001), age (r=0.32, p<0.01), brachial systolic BP (r=0.34, p< 0.01) and aortic systolic BP (r=0.34, p<0.01) correlated with IMT. In men, age (r=0.41, p<0.001), diabetes duration (r=0.25, p<0.01), AG (r=0.22, p<0.01), aortic sys-tolic BP (r=0.21, p<0.01), brachial systolic BP (r=0.21, p<0.01) and body weight (r=0.16, p<0.05) correlated with IMT. In multiple linear regression analyses, AG and aortic systolic BP, but not brachial systolic BP, were age-independent determinants of IMT in men and women. In all patients, increased AG (adjusted for sex, age and heart rate) correlated with longer duration of diabetes, urinary albumin excretion and IMT. Conclusions/interpretation: Measures of central systolic pressure correlate with carotid IMT, independently of age and other risk markers.
2014
Objective: To examine the association of common carotid intima media thickness (CCA-IMT) with risk factors of atherosclerosis in type 2 diabetes and hypertension patients. Methods: This cross-sectional descriptive study was carried out in 14 type 2 diabetes, 15 hypertension and 15 control subjects. CCA-IMT and ankle brachial index (ABI) were measured by ultrasonography. Anthropometric characteristics of each subject were also taken. Results: type 2 diabetes group had higher mean CIMT values as compared to the other two groups. ABI was significantly inversely related to CIMT in type 2 diabetes and hypertension group. Conclusion: CIMT showed association with ABI and duration in type 2 diabetes and hypertension groups
Vascular Disease in Diabetic Women: Why Do They Miss the Female Protection?
Experimental Diabetes Research, 2012
Gender plays a pivotal role in the onset as well as in the progression of the cardiovascular disease with a higher morbidity and mortality being detected in men with respect to women. Type 2 Diabetes Mellitus (T2DM) may reduce gender-related differences in the prevalence of cardiovascular disease by fading the vascular protective effects afforded by estrogen in females. This article will discuss the role of sex and sex hormones on the incidence and mechanisms involved in vascular dysfunction associated to T2DM, which might explain why women with T2DM lack the vascular protection.
Effects of coexisting hypertension and type II diabetes mellitus on arterial stiffness
Journal of Human Hypertension, 2004
Hypertension (HT) is frequently associated with diabetes mellitus (DM) and its prevalence doubles in diabetics compared to the general population. This high prevalence is associated with increased stiffness of large arteries, which often precedes macrovascular events. The aim of our study was to evaluate the influence of HT and type II DM on aortic stiffness in patients with one disease or the other compared to those with both HT and type II DM. We studied 220 patients, 50 with type II DM (Group A), 50 with HT (Group B), 85 with both diseases (Group C), and 35 healthy subjects (HS). Regional arterial stiffness was assessed by automatic measurement of the carotid-femoral pulse wave velocity (PWV). For each patient, we evaluated: age, sex, body mass index, smoking habit, heart rate, SBP/DBP, pulse pressure (PP), mean BP, fasting glucose, lipid profile, uric acid, and fibrinogen. Group C had significantly more women and non smokers and the highest PP (61714 mmHg). Of biochemical parameters, only fibrinogen was higher in Group A and in Group C (Po0.01 and Po0.001, respectively). Group C had a significantly higher PWV than the other four groups (Po0.0001). Stepwise forward regression analysis showed that fasting glucose was the first independent determinant of PWV (Po0.0001). In conclusion, this study shows that patients with DM and HT have higher arterial stiffness compared to HS and those with one disease or the other. Fasting glucose is the major independent determinant of PWV, which may be used as a relevant tool to assess the influence of cardiovascular risk factors on arterial stiffness in high-risk patients.
Sex differences in age-related stiffening of the aorta in subjects with type 2 diabetes
…, 2004
Hypertension and type 2 diabetes are associated with increased aortic pulse wave velocity (PWV), a measure of aortic stiffness and a powerful risk factor for cardiovascular events. The association of hypertension with type 2 diabetes may obscure the degree to which diabetes rather than hypertension contributes to an elevated PWV. The objective of this study was to determine whether the presence of type 2 diabetes is associated with an elevated PWV compared with nondiabetic subjects matched for mean arterial blood pressure. PWV was determined by measuring carotid to femoral transit time using applanation tonometry in 186 subjects (104 women) with (nϭ93) and without (nϭ93) type 2 diabetes. Diabetic and nondiabetic subjects were matched for age and mean arterial pressure (to Ϯ5 years and 5 mm Hg, respectively). PWV was strongly correlated with age and mean arterial blood pressure (Rϭ0.59 and 0.29 respectively, each PϽ0.0001). PWV increased significantly more with age in women with diabetes (slope of regression lineϮSE: 0.19Ϯ0.03 m ⅐ s Ϫ1 ⅐ year Ϫ1) than in nondiabetic women (0.08Ϯ0.02 m ⅐ s Ϫ1 ⅐ year Ϫ1 , PϽ0.01 for difference). In men, however, the age-related increase in PWV was similar in diabetic (0.15Ϯ0.03 m ⅐ s Ϫ1 ⅐ year Ϫ1) and nondiabetic subjects (0.13Ϯ0.03 m ⅐ s Ϫ1 ⅐ year Ϫ1 , PϭNS). The interaction of diabetic status with age and with sex was significant (Pϭ0.01). Type 2 diabetes is associated with a greater age-related stiffening of the aorta in women compared with men, and this is not explained by hypertension. (Hypertension. 2004;44:67-71.