title: Aortic pulse wave velocity predicts incident cardiovascular events in patients with type 2 diabetes treated in primary care.
abstract: The aim was to evaluate the predictive value of aortic pulse wave velocity (aPWV) on incident cardiovascular events in patients with type 2 diabetes without previous cardiovascular disease who were treated in primary care, after adjustment for traditional risk factors.
  
  
  
  We measured aPWV in 627 patients who participated in the epidemiological study CARDIPP (Cardiovascular Risk Factors in Patients with Diabetes-a Prospective Study in Primary Care; ClinicalTrials.gov identifier NCT01049737) and who did not have previously known myocardial infarction or stroke. The outcome variable was a composite endpoint consisting of cardiovascular mortality, hospitalization for myocardial infarction and hospitalization for stroke.
  
  
  
  During a median follow-up time of almost eight years, the unadjusted HR per each increment of aPWV by 1m/s was 1.239 (95% CI 1.114-1.379, P<0.001) for the primary endpoint. Following adjustments for age, sex, diabetes duration, office systolic blood pressure, resting heart rate, total cholesterol, HbA1c, estimated glomerular filtration rate and smoking status, the adjusted hazard ratio was 1.142 (95% CI 1.003-1.301, P=0.044).
  
  
  
  In primary preventive patients with type 2 diabetes treated in primary care, aPWV predicted a composite outcome of incident cardiovascular events independently of diabetes-specific and traditional risk factors.
authors.affiliation: Department of Internal Medicine and Department of Medical and Health Sciences, Linköping University, 601 74 Norrköping, Sweden. Electronic address: magnus.wijkman@liu.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Wijkman
authors.affiliation: Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden. Electronic address: toste.lanne@liu.se.
authors.forename: Toste
authors.initials: T
authors.lastname: Länne
authors.affiliation: Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden. Electronic address: carl.johan.ostgren@liu.se.
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Östgren
authors.affiliation: Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden. Electronic address: fredrik.nystrom@regionostergotland.se.
authors.forename: Fredrik H
authors.initials: FH
authors.lastname: Nystrom
mesh_terms: D001011:Aorta; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors
keywords: Arterial stiffness; Diabetes mellitus; Epidemiology; Hypertension; Macrovascular complications