title: Adverse effect of diabetes and hyperglycaemia on arterial stiffness in Europeans, South Asians, and African Caribbeans in the SABRE study.
abstract: OBJECTIVE
  Ethnic minority groups in the U.K. experience marked differences in cardiovascular disease risk. We investigated differences in arterial central haemodynamics, stiffness, and load in a tri-ethnic population-based cohort.
  
  
  METHODS
  A total of 1312 participants (70 ± 6 years) underwent echocardiography and measurement of brachial and central blood pressure to assess central arterial haemodynamics including central pulse pressure (cPP), arterial stiffness [cPP/stroke volume (SV)], systemic vascular resistance (SVR), and load (Ea).
  
  
  RESULTS
  Brachial and central SBPs were similar in all ethnic groups. Compared with Europeans, cPP, cPP/SV, and Ea were higher in South Asians. In contrast, cPP/SV was lower in African Caribbeans despite higher mean arterial pressure, higher SVR, and higher diabetes prevalence. cPP/SV and Ea remained significantly higher in South Asians and significantly lower in African Caribbeans after multivariate adjustment. Diabetes and higher HbA1c were more strongly associated with higher cPP/SV in South Asians than in Europeans (Pinteraction = 0.045 and 0.005, respectively); higher HbA1c was also more strongly associated with increased Ea in South Asians than Europeans (Pinteraction = 0.01). There was no evidence of an interaction between glycaemia and cPP/SV in African Caribbeans.
  
  
  CONCLUSIONS
  Compared with Europeans, South Asians have unfavorable arterial function. Diabetes and hyperglycaemia have a more deleterious effect on cPP/SV and Ea in South Asians. In contrast, African Caribbeans have more favourable arterial function than Europeans and South Asians. These differences may contribute to the differential ethnic rates of cardiovascular disease.
authors.affiliation: aUCL Institute of Cardiovascular Science, University College LondonbInstitute of Population Health, St Georges UniversitycInternational Centre for Circulatory Health, Imperial College LondondImperial College NHS Trust, London, UK.
authors.forename: Chloe M
authors.initials: CM
authors.lastname: Park
authors.forename: Therese
authors.initials: T
authors.lastname: Tillin
authors.forename: Katherine
authors.initials: K
authors.lastname: March
authors.forename: Siana
authors.initials: S
authors.lastname: Jones
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.forename: Jamil
authors.initials: J
authors.lastname: Mayet
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: Alun D
authors.initials: AD
authors.lastname: Hughes
mesh_terms: D000368:Aged; D001208:Asia / Q000208:ethnology; D044466:Asian People; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000208:ethnology; D017691:Caribbean Region / Q000208:ethnology; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000208:ethnology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006113:United Kingdom / Q000453:epidemiology; D014655:Vascular Resistance; D059289:Vascular Stiffness; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human