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.

Open Access

This is an open access article distributed under the CC BY-NC license.

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  -