The control of blood pressure might be important in delaying progression of arterial aging in patients with type 2 diabetes mellitus

Objective: Arterial stiffness, as assessed by the brachial-ankle pulse wave velocity (baPWV), is associated with arterial aging and has been consistently linked to cardiovascular disease. The factors involved in reducing the progression of arterial stiffness in patients with type 2 diabetes mellitus (DM) have not yet been fully established. Methods: Of 478 patients who underwent two baPWV measurements (at baseline and 1 year later) at the Department of Internal Medicine, St Vincent's Hospital, from November 2009 to June 2011, 341 subjects were enrolled in this study (male to female ratio =150:191; mean age, 62.1±7.7 years). The 341 subjects were over the age of 50 with type 2 DM, were diagnosed without peripheral artery disease, and 170 if the subjects (50%) had hypertension. Results: baPWV at baseline increased in a linear manner along with age (β=22.8, t=10.855; P<0.0001, R²=0.258). After 1 year follow-up, the change in baPWV (ΔbaPWV) was variable (median 32.7 cm/s [approximate range, -557 to ~745]). In multiple linear regression, the change in systolic blood pressure (β=7.142, 95% confidence interval =4.557-9.727; P<0.0001, R2=0.305) was associated with ΔbaPWV during follow-up. The change in glycated hemoglobin (HbA_Ic) and a glycemic control of keeping HbA_Ic levels below 7.0% were not associated with ΔbaPWV. Conclusion: We found that the variation of blood pressure was associated with the progression of vascular aging of the large- to middle-sized arteries in patients with type 2 DM. Therefore, control of blood pressure might be important in reducing arterial aging or PWV in patients with type 2 DM.