Functional arterial stiffness assessed by changes in pulse wave velocity after exercise reflects the severity of atherosclerosis in hypertensive patients with or without type 2 diabetes mellitus

Abstract

Objective: The purpose of this study was to determine whether or not functional arterial stiffness, as assessed by changes in brachial-ankle pulse wave velocity (ba-PWV) after exercise, reflects the severity of atherosclerosis in hypertensive patients with or without type 2 diabetes mellitus (DM). Methods: Treated hypertensive patients were divided into hypertension (HT) (n = 102, 62 ± 10 yr) and HT + DM (n = 76, 62 ± 9 yr) groups. Changes in ba-PWV before and after the cycle ergometer exercise at moderate intensity were calculated as an indicator of functional arterial stiffness (⊿PWV). We further divided patients into two subgroups based on ⊿PWV (⊿PWV [-] and ⊿PWV[+] subgroups) and compared their carotid intima-media thickness (cIMT). Stepwise regression analysis was performed with cIMT as a dependent variable, and clinical characteristics, functional arterial stiffness, vascular endothelial function, and autonomic nervous activity as independent variables. Results: cIMT was significantly thicker in the ⊿PWV(+) subgroup than in the ⊿PWV(-) subgroup in both the HT and the HT + DM groups (P < 0.05 and P < 0.05, respectively). Stepwise regression analysis revealed that age, ⊿PWV, and high-density lipoprotein cholesterol (HDL-C) were significant independent limiting factors for cIMT (age: β = 0.314, P < 0.001; ⊿PWV: β = 0.257, P < 0.001; HDL-C: β = -0.205, P < 0.01) (R 2 = 0.21, P < 0.001). Conclusion: Functional arterial stiffness reflects the severity of atherosclerosis in HT patients with or without type 2 DM