Disclosures: The authors report no relevant financial disclosures.
May 16, 2022
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Arterial stiffness better predicts diabetes risk vs. hypertension

Disclosures: The authors report no relevant financial disclosures.
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Arterial stiffness better predicts type 2 diabetes risk than hypertension, with comorbid elevated BP and arterial stiffness more than doubling risk for the disease compared with those with ideal vascular function, researchers reported.

“Identification of individuals at high risk of developing type 2 diabetes is of utmost importance, since early intervention can help prevent the onset and slow the progress of the condition,” Anxin Wang, PhD, a researcher at the China National Clinical Research Center for Neurological Diseases at Beijing Tiantan Hospital in Beijing, said in a press release. “Since people with either hypertension or arterial stiffness tend to have a higher risk of developing type 2 diabetes, we investigated which of these factors may be more effective in predicting an individual’s future risk of type 2 diabetes.”

Graphical depiction of data presented in article
Data were derived from Tian X, et al. Hypertension. 2022;doi:10.1161/HYPERTENSIONAHA.122.19256.

Wang and colleagues analyzed data from 11,156 participants from the Kailuan study, an ongoing prospective study conducted in Tangshan, China. Arterial stiffness was assessed by brachial-ankle pulse wave velocity. Researchers compared diabetes risk between individuals with normotension and normal arterial stiffness (ideal vascular function), those with normotension with elevated arterial stiffness, those with hypertension with normal arterial stiffness and those with hypertension with elevated arterial stiffness.

The findings were published in Hypertension.

During a median follow-up of 6.16 years, 6.88% of participants developed diabetes.

Compared with ideal vascular function group, the highest risk for diabetes was observed in hypertension with elevated arterial stiffness group (HR = 2.42; 95% CI, 1.93-3.03), followed by those with normotension and elevated arterial stiffness (HR = 2.11; 95% Cl, 1.68-2.66). Those with hypertension with normal arterial stiffness were less likely than the other two nonideal groups to develop diabetes, but still had elevated risk compared with the ideal group, with an HR of 1.48 (95% Cl, 1.08-2.02). Results persisted in subgroup analyses adjusted for mean arterial pressure and diastolic BP, as well as sensitivity analyses using 130/80 mm Hg or antihypertensive medication use as another definition of hypertension.

Analyses that added arterial stiffness to a conventional model including traditional risk factors had a higher incremental effect on the predictive value for diabetes than the addition of hypertension (adding arterial stiffness: C statistic, 0.707; integrated discrimination improvement, 0.65%; net reclassification improvement, 40.48%; adding hypertension: C statistic, 0.695; integrated discrimination improvement, 0.28%; net reclassification improvement, 34.59%), according to researchers.

“We were surprised to find that people with increased arterial stiffness were more likely to develop type 2 diabetes, whether they had high blood pressure or not,” Wang said in the release. “These results provide strong evidence that measuring arterial stiffness may be a better predictor than blood pressure in determining an individual’s future risk of type 2 diabetes.”