Increased pulse wave velocity is not associated with elevated augmentation index in patients with diabetes.
OBJECTIVE
Increased arterial stiffness is a risk factor for cardiovascular disease and is a feature associated with diabetes. Pulse wave velocity (PWV) is an accepted index of arterial stiffness and augmentation index (AI) derived from radial applanation tonometry has been advocated as a measurement of arterial stiffness. This study compares the relationship between PWV and AI in people with and without diabetes.


METHODS
A total of 66 people with diabetes and 66 age-matched non-diabetic controls were studied. Central aortic pressure waves were generated using applanation tonometry over the radial artery and used to calculate AI. Carotid-femoral PWV (PWVcf) was measured simultaneously.


RESULTS
Relative to controls, diabetes was associated with increased pulse pressure (PP) and PWVcf (P < 0.01). In contrast, AI did not differ between groups even after adjustment for heart rate. This observation remained consistent irrespective of diabetes type, arterial site, and the presence or absence of antihypertensive therapy. Multiple regression analysis revealed diabetes to be a significant determinant of PWVcf, but not AI.


CONCLUSIONS
PP and PWVcf are increased in people with diabetes, but this is not associated with increased AI. These findings conclusively demonstrate that AI is not a reliable measure of arterial stiffness in people with diabetes.
Lacy
Peter S
PS
Department of Cardiovascular Sciences, Cardiovascular Research Institute, University of Leicester, Leicester LE2 7LX, UK. PSL2@le.ac.uk
O'Brien
David G
DG
Stanley
Adrian G
AG
Dewar
Mairead M
MM
Swales
Philip P R
PP
Williams
Bryan
B
D001783:Blood Flow Velocity; D001794:Blood Pressure; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011674:Pulse; D017534:Radial Artery / Q000503:physiopathology; D012044:Regression Analysis