Diabetes Care, Vol 21, Issue 1 99-103, Copyright © 1998 by American Diabetes Association
Carotid artery stiffness is increased in microalbuminuric IDDM patients
J Lambert, RA Smulders, M Aarsen, AJ Donker and CD Stehouwer
Department of Internal Medicine, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
OBJECTIVE: In IDDM, the development of microalbuminuria, which is
associated with an elevation in blood pressure within the normal range, is
a risk factor for future cardiovascular disease. Vascular stiffness might
be one of the factors involved because it increases systolic blood pressure
and the workload of the heart. RESEARCH DESIGN AND METHODS: We investigated
carotid artery stiffness with a noninvasive ultrasound method in 24
microalbuminuric and 53 normoalbuminuric IDDM patients and in 54 healthy
control subjects. RESULTS: The distensibility coefficient, a measure of
intrinsic vascular wall elasticity, was decreased in microalbuminuric IDDM
(21.6 x 10(-3)/kPa) as compared with normoalbuminuric IDDM (24.8 x
10(-3)/kPa) and control subjects (25.9 x 10(-3)/kPa; P = 0.02). This result
was based on a higher blood pressure in microalbuminuric patients. After
correction for the difference in blood pressure, the distensibility
coefficients were similar in the three groups. In the two diabetic patient
groups taken together, age, blood pressure, female sex, diabetes duration,
and cigarette smoking were determinants of a decreased distensibility.
CONCLUSIONS: Blood pressure is a major determinant of increased arterial
stiffness in microalbuminuric IDDM patients. Increased arterial stiffness
may contribute to the accelerated progression of complications if
concomitant hypertension exists.