Background: To determine whether prediabetes and diabetes in older adults are associated with arterial stiffness measured in central and peripheral arteries and to examine characteristics that modify these associations. Methods: Cohort members attending the 5th exam (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) study had pulse wave velocity (PWV) measures performed at the carotid-femoral (cfPWV), brachial-ankle (baPWV), and femoral-ankle (faPWV) segments. Fasting glucose ≥126mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or currently taking diabetes medication defined diabetes. Fasting glucose 100-125mg/dl or HbA1c 5.7%-6.4% among those without diabetes defined prediabetes. Cross-sectional associations were modeled using multivariable linear regression. Results: Among 4,279 eligible participants with cfPWV measures (mean age 75 years), 22% were African-American, 25.5% had diabetes, and 54.7% had prediabetes. Compared to those with normal glucose, cfPWV was 95.8cm/s higher (stiffer) on average for those with diabetes (for reference: being 1 year older was associated with 14.4cm/s higher cfPWV). Similar findings were seen for diabetes and baPWV, although attenuated. Interestingly, faPWV was 17.6cm/s lower for those with diabetes compared to normal glucose. There was a significant positive association between baPWV and prediabetes. Among those with diabetes, cfPWV was higher for those with albuminuria, reduced kidney function, duration of diabetes ≥10 years, and elevated HbA1c (HbA1c ≥7). Conclusion: Among older adults, diabetes is associated with higher central arterial stiffness and lower peripheral arterial stiffness, and prediabetes is associated with higher baPWV. Cross-sectionally, the magnitude of the effect of diabetes on central stiffness is equivalent to 6 years of arterial aging.
Bibliographical noteFunding Information:
The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268 201100009C, HHSN268201100010C, HHSN26820110001 1C, and HHSN268201100012C). The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the US Department of Health and Human Services. E.S. was supported by NIH/NIDDK grant K24 DK106414. The authors thank the staff and participants of the ARIC study for their important contributions.
© 2016 American Journal of Hypertension, Ltd 2016. All rights reserved.
- Arterial stiffness
- Blood pressure
- Peripheral arterial stiffness
- Pulse wave velocity