title: Carotid femoral pulse wave velocity in type 2 diabetes and hypertension: capturing arterial health effects of step counts.
abstract: Optimal medication use obscures the impact of physical activity on traditional cardiometabolic risk factors. We evaluated the relationship between step counts and carotid-femoral pulse wave velocity (cfPWV), a summative risk indicator, in patients with type 2 diabetes and/or hypertension.
  
  
  
  Three hundred and sixty-nine participants were recruited (outpatient clinics; Montreal, Quebec; 2011-2015). Physical activity (pedometer/accelerometer), cfPWV (applanation tonometry), and risk factors (A1C, Homeostatic Model Assessment-Insulin Resistance, blood pressure, lipid profiles) were evaluated. Linear regression models were constructed to quantify the relationship of steps/day with cfPWV.
  
  
  
  The study population comprised 191 patients with type 2 diabetes and hypertension, 39 with type 2 diabetes, and 139 with hypertension (mean ± SD: age 59.6 ± 11.2 years; BMI 31.3 ± 4.8 kg/m; 54.2% women). Blood pressure (125/77 ± 15/9 mmHg), A1C (diabetes: 7.7 ± 1.3%; 61 mmol/mol), and low-density lipoprotein cholesterol (diabetes: 2.19 ± 0.8 mmol/l; without diabetes: 3.13 ± 1.1mmol/l) were close to target. Participants averaged 5125 ± 2722 steps/day. Mean cfPWV was 9.8 ± 2.2 m/s. Steps correlated with cfPWV, but not with other risk factors. A 1000 steps/day increment was associated with a 0.1 m/s cfPWV decrement across adjusted models and in subgroup analysis by diabetes status. In a model adjusted for age, sex, BMI, ethnicity, immigrant status, employment, education, diabetes, hypertension, medication classes, the mean cfPWV decrement was 0.11 m/s (95% confidence interval -0.2, -0.02).
  
  
  
  cfPWV is responsive to step counts in patients who are well controlled on cardioprotective medications. This ability to capture the 'added value' of physical activity supports the emerging role of cfPWV in arterial health monitoring.
authors.affiliation: aMcGill University bResearch Institute of the McGill University Health Center cUniversité de Montréal, Quebec, Canada.
authors.forename: Kaberi
authors.initials: K
authors.lastname: Dasgupta
authors.forename: Ellen
authors.initials: E
authors.lastname: Rosenberg
authors.forename: Lawrence
authors.initials: L
authors.lastname: Joseph
authors.forename: Luc
authors.initials: L
authors.lastname: Trudeau
authors.forename: Natasha
authors.initials: N
authors.lastname: Garfield
authors.forename: Deborah
authors.initials: D
authors.lastname: Chan
authors.forename: Mark
authors.initials: M
authors.lastname: Sherman
authors.forename: Rémi
authors.initials: R
authors.lastname: Rabasa-Lhoret
authors.forename: Stella S
authors.initials: SS
authors.lastname: Daskalopoulou
mesh_terms: D061725:Accelerometry; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002339:Carotid Arteries; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005263:Femoral Artery; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human