Arterial stiffness was a more effective predictor of the risk of developing type 2 diabetes than hypertension, suggests a new study published in the journal Hypertension.¹ Patients who were hypertensive and also had increased arterial stiffness doubled their risk of type 2 diabetes.

For the present study, Tian et al examined data from 11,156 participants from the KaiLuan study with the aim to determine a correlation between hypertension, artery wall stiffness and the risk of diabetes. Every two years, the researchers measured the resting BP and collected fasting blood samples from the participants. The arterial wall stiffness was measured using the brachial-ankle pulse wave velocity. Resting BP ≥ 140/90 mm was defined as hypertension for the study. The risk of diabetes was compared among three groups of patients: those with normal BP and normal arterial stiffness, normotensive patients with raised arterial stiffness and hypertensive patients with either increased or normal arterial stiffness.

After a follow up period of 6 years (median), 768 participants (~7%) developed type 2 diabetes. Hypertensive patients with raised arterial stiffness were at the greatest risk of developing type 2 diabetes with hazard ratio of 2.42. Normotensive participants with increased arterial stiffness came next (HR 2.11). Hypertensive participants with normal arterial stiffness had the least risk of type 2 diabetes (HR 1.48).

Older participants, those who had higher BMI and heart rate, those who were smokers and consumed alcohol were more likely to have high BP and elevated arterial stiffness. Participants with increased arterial stiffness tended to have higher levels of fasting blood glucose and cholesterol when compared to those who had normal arterial stiffness.

This analysis of more than 11,000 participants has shown an association of diabetes with hypertension and arterial stiffness. It has also demonstrated that compared to hypertension, arterial stiffness was a better predictor for the risk of diabetes later on in life. Early diagnosis allows timely intervention and prevents or delays onset of diabetes-related complications. The authors however advocate the need for more research to further investigate the association between hypertension, arterial stiffness and type 2 diabetes to understand the underlying mechanisms and define optimum cut-offs.

Reference

1. Tian X, et al. Hypertension, arterial stiffness, and diabetes: a prospective cohort study. Hypertension. 2022 May 16;101161HYPERTENSIONAHA12219256. doi: 10.1161/HYPERTENSIONAHA.122.19256.