Abstract 13390: Diabetes is Related to Higher Central Blood Pressure

Abstract

Background. Central blood pressure (BP) is directly related LV overload as well as blood supply to the heart and brain. It may also directly damage coronary and carotid artery walls being one of the most important causes of atherosclerosis. Several studies have shown closer correlation between end-organ damage and central than peripheral BP. Central BP was also shown to better predict CV risk as compared to brachial BP. Diabetes is related to at least two-fold increased in CV risk. The influence of diabetes on central BP values is unknown. Aim. To assess the independent influence of diabetes on the ascending aortic BP values.

Methods. BP in the ascending aorta was measured in 400 patients (200 with type 2 diabetes and 200 patients without diabetes) undergoing non-emergency coronary angiography. Brachial BP was measured using a sphygmomanometer. Both groups did not differ in respect of age (62.9±9.1 vs. 63.0±9.2 years; p=NS) and sex (131 men and 69 women in both groups). General regression model was used to assess the independent influence of diabetes on BP.

Results. Systolic, diastolic, and mean brachial BP did not differ between both groups (138.8±21.3 vs. 133.7±20.3 mmHg; p=0.06; 83.4±12.0 vs. 82.6±10.7 mmHg; p=0.81; 101.9±14.0 vs. 99.6±13.0 mmHg; p=0.27 in diabetics and non-diabetics resp.) but brachial pulse pressure was higher in diabetics (55.4±15.3 vs. 51.1±14.2; p=0.02). Central BP values are shown in the table. In multivariable analysis diabetes was related to higher ascending aortic systolic BP by 2.7 (95% confidence intervals: 1.7-3.8) mmHg and pulse pressure by 4.1 (2.5-5.7) mmHg as well as higher brachial pulse pressure by 1.8 (0.2-3.3) mmHg. The differences in mean and diastolic (both brachial and central) BP as well as brachial systolic BP were not significant in multivariable analysis.

Conclusions. Diabetes is independently related to higher values of systolic and pulse pressure in the ascending aorta. This may partly explain the higher CV risk in diabetics.