title: Augmentation of central arterial pressure as a marker of atherosclerosis in patients with type 2 diabetes.
abstract: Macrovascular disease is the most common cause of morbidity and mortality in diabetic patients. With the increasing numbers of patients with type 2 diabetes, a simple, noninvasive method is needed to detect atherosclerosis. Augmentation represents the difference between the second and first peaks of the central arterial pressure waveform in systole and is a measure of systemic arterial stiffness, which causes the pressure wave to rebound. We investigated whether augmentation could serve as a marker of atherosclerosis in patients with type 2 diabetes. Central arterial pressure and degree of its augmentation by pulse wave rebound were measured sphygmographically in 208 consecutive patients with type 2 diabetes and 117 healthy control subjects. The relationship between augmentation and carotid atherosclerosis detected by carotid ultrasonography was investigated in a subgroup of 81 diabetic patients. Augmentation was greater in diabetic patients than control subjects (13.2+/-6.9 vs. 9.4+/-5.7 mm Hg, P<0.0001). The positive correlation between augmentation and intima-media thickness (r=0.309, P=0.0051) and between augmentation and plaque score (r=0.304, P=0.0059) were found in patients with type 2 diabetes. Augmentation was greater in diabetic patients with cardiovascular disease (n=47) than without (n=161; 15.1+/-8.4 vs. 12.6+/-6.3 mm Hg, P=0.031). Augmentation of central arterial pressure is a reliable marker for atherosclerosis in patients with type 2 diabetes. This simple, noninvasive determination would permit large-scale, early screening for atherosclerosis in patients with type 2 diabetes, who are at increased risk for cardiovascular disease.
authors.affiliation: The Department of Endocrinology and Hematology, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzaki-cho, Abeno-ku, Japan. sayarinapm@hotmail.com
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Mogami
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Ohnishi
authors.forename: Chizuko
authors.initials: C
authors.lastname: Hirata
authors.forename: Naoko
authors.initials: N
authors.lastname: Ichio
authors.forename: Katsuya
authors.initials: K
authors.lastname: Wada
authors.forename: Kenji
authors.initials: K
authors.lastname: Kamiuchi
authors.forename: Masako
authors.initials: M
authors.lastname: Shigeta
authors.forename: Manabu
authors.initials: M
authors.lastname: Sawada
authors.forename: Goji
authors.initials: G
authors.lastname: Hasegawa
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography / Q000379:methods