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The Relationship Between Glycemic Control and Concomitant Hypertension on Arterial Stiffness in Type II Diabetes

Authors Nuamchit T, Siriwittayawan D, Thitiwuthikiat P

Received 29 May 2020

Accepted for publication 3 August 2020

Published 25 August 2020 Volume 2020:16 Pages 343—352

DOI https://doi.org/10.2147/VHRM.S265157

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Konstantinos Tziomalos


Teonchit Nuamchit, Duangduan Siriwittayawan, Piyanuch Thitiwuthikiat

Department of Cardiothoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand

Correspondence: Piyanuch Thitiwuthikiat
Department of Cardiothoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Thapho, Muang, Phitsanulok 65000, Thailand
Tel +66 55 966 371
Fax +66 55 966 234
Email piyanucht@nu.ac.th

Purpose: The impact of glycemic control on macrovascular complications and arterial stiffness in type II diabetes (T2D), as well as the extent of additive effect of hypertension, is unclear. The aims of this study were to investigate the impact of glycemic control on the cardio-ankle vascular index (CAVI), an indicator of arterial stiffness, and to determine the relative risk of concomitant diabetes and hypertension with arterial stiffness.
Methods: One hundred and nine participants were enrolled and classified as non-diabetes (n= 37) and diabetes (n=72); the diabetic group was further identified as controllable and uncontrollable T2D depending on their hemoglobin A1c (HbA1c) levels. Univariate and multiple regression analyses were used to assess the association between CAVI and glycemic control status and hypertension. Relative risk analysis for abnormal CAVI with exposure to diabetes and hypertension was investigated.
Results: In all participants, age, systolic blood pressure, body mass index, and fasting blood sugar were independent predictors of CAVI. In diabetic participants, glycemic control status or HbA1c levels did not significantly correlate with CAVI. Systolic blood pressure was an independent predictor for CAVI with β = 0.26. In addition, the coexistence of diabetes together with hypertension was significantly associated with a 2.4-fold increase in the risk of abnormal CAVI (95% CI, 1.410– 4.184; p < 0.001).
Conclusion: This study demonstrates that HbA1c as well as fasting blood sugar levels in diabetic participants do not correlate with arterial stiffness. Concomitant diabetes and hypertension significantly increase the risk of arterial stiffness.

Keywords: arterial stiffness, cardio-ankle vascular index, diabetes, glycemic control, hypertension

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