P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY

DOI

10.1016/j.artres.2015.10.250How to use a DOI?

Abstract

Introduction: Arterial remodeling is an adaptive phenomenon aimed at maintaining circumferential wall stress (CWS) within operating limits. It is characterized by widening of the inter-adventitial diameter (IAD) and increases in intima-media thickness (IMT). This process is maladaptive when CWS increases despite remodeling. Type 2 Diabetes (T2D) is associated with increased carotid CWS, but its association with cardiovascular disease (CVD) is unknown.

Methods: The cohort consisted of 277 individuals with normal glucose metabolism (NGM), 162 with impaired glucose metabolism (IGM) and 131 with T2D (age 69.6 ± 6.4, 51.0% women, systolic pressure 141.9 ± 20.6 mmHg, bmi 26.9 ± 3.5 kg/m2, prior CVD 50.1%). Carotid arterial properties (IAD, IMT, lumen diameter (LD)) were quantified by ultrasonography. CWS was calculated as PP·LD/(2IMT), where PP is the brachial pulse pressure. A morbidity and mortality register was kept on all individuals.

Results: After a median of 7.7 [IQR 7.0-8.1] years of follow up, 130 CVD events and 93 deaths were recorded. CWS was 31.7, 31.5 and 34.4 kPa in NGM, IGM and T2D, respectively (Ptrend= 0.06). Greater CWS was associated with incident CVD in T2D only (hazard ratio(95%CI) per SD increase in CWS for NGM: 0.92 (0.70–1.21); IGM: 1.02 (0.66–1.58) and T2D 1.52 (1.09–2.14), after adjustment for age, sex, height and other CVD risk factors.. No associations were observed between CWS and all-cause mortality.

Conclusion: T2D is associated with greater CWS compared to NGM and IGM. Greater carotid CWS is associated with incident CVD in T2D but not in NGM or IGM.

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TY  - JOUR
AU  - Veronica Onete*
AU  - Ronald Henry
AU  - Miranda Schram
AU  - Jacqueline Dekker
AU  - Giel Nijpels
AU  - Coen Stehouwer
PY  - 2015
DA  - 2015/11/23
TI  - P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY
JO  - Artery Research
SP  - 16
EP  - 17
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.250
DO  - 10.1016/j.artres.2015.10.250
ID  - Onete*2015
ER  -