EVALUATION OF ARTERIAL STIFFNESS USING BRACHIAL-ANKLE PULSE WAVE VELOCITY IN TYPE 2 DIABETES PATIENTS AT 175 MILITARY HOSPITAL
DOI:
https://doi.org/10.59354/ydth175.2025.424Từ khóa:
clinical characteristics, paraclinical characteristics, arterial stiffness, pulse wave velocityTóm tắt
Objective: Assess arterial stiffness using brachial-ankle pulse wave velocity (baPWV) and its correlation with certain clinical and subclinical characteristics in type 2 diabetes (T2DM) patients at 175 Military Hospital.
Subjects and Methods: A cross-sectional descriptive study was conducted on 200 participants (160 patients with T2DM and 40 in age and sex-matched healthy control group) at Military Hospital 175 from June 2022 to June 2024. BaPWV was measured by the OMRON VP-1000 PLUS machine.
Results: Patients with T2DM had a mean age of 59.95 ± 12.62 years, with males accounting for 45%. The most common atherosclerotic cardiovascular risk factors were hypertension (HTN) and dyslipidemia (72.5% and 71.25%, respectively). The T2DM group had a significantly higher mean baPWV compared with the healthy control group matched for age and sex (1821.22 ± 433.56 vs. 1544.93 ± 302.36 cm/s; p < 0.05), as well as a significantly higher prevalence of arterial stiffness (baPWV > 1450 cm/s) (45% vs. 21.88%; p = 0.003). In patients with T2DM, baPWV showed a statistically significant positive correlation with age (r = 0.477; p < 0.05), heart rate (r = 0.20; p = 0.11), and mean arterial pressure (r = 0.441; p < 0.05). Arterial stiffness in patients with T2DM was significantly associated with hypertension [OR 4.75 (2.14–10.53), p < 0.001], metabolic syndrome [OR 3.53 (1.60–7.76), p = 0.004], chronic kidney disease [OR 2.94 (1.20–7.25), p = 0.016], poor glycemic control with HbA1c > 6.5% [OR 3.77(1.41–4.48), p = 0.01], and microalbuminuria [OR 1.91 (0.84–4.33), p < 0.01]. Patients with T2DM and concomitant hypertension had significantly higher baPWV compared with those without hypertension (1910.22 ± 439.57 vs. 1586.65 ± 317.47 cm/s; p < 0.001). Among patients with T2DM and hypertension, those who achieved target blood pressure control had significantly lower baPWV than those who did not achieve blood pressure targets (1828.09 ± 400.02 vs. 2004.28 ± 467.11 cm/s; p = 0.03).
Conclusion: In patients with T2DM, mean baPWV values and the prevalence of increased arterial stiffness were significantly higher than in healthy controls matched for age and sex. baPWV was significantly associated with age, mean arterial pressure, and heart rate. Arterial stiffness was significantly associated with several atherosclerotic cardiovascular risk factors, including hypertension, metabolic syndrome, chronic kidney disease, poor glycemic control (HbA1c > 6.5%), and positive microalbuminuria. Patients with T2DM and hypertension who achieved target blood pressure control had significantly lower baPWV compared with those who did not achieve blood pressure targets.
Tài liệu tham khảo
1. Cosentino, F., et al., 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). 2020. 41(2): p. 255-323.
2. Stehouwer, C.D., R.M. Henry, and I. Ferreira, Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia, 2008. 51(4): p. 527-39.
3. Laurent, S., et al., Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J, 2006. 27(21): p. 2588-605.
4. Mancia, G., et al., 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens, 2023. 41(12): p. 1874-2071.
5. Yamashina, A., et al., Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res, 2003. 26(8): p. 615-22.
6. Tanaka, S., et al., The predictive value of the borderline ankle-brachial index for long-term clinical outcomes: An observational cohort study. Atherosclerosis, 2016. 250: p. 69-76.
7. Pham Tuan Duong, Quach Huu Trung, and T.T.T. Huong. Study of the Components of Arterial Stiffness in Patients with Type 2 Diabetes Mellitus. 2016. 14 RESEARCH ARTICLES
8. Nguyen, K., et al., A cross-sectional study to evaluate diabetes management, control and complications in 1631 patients with type 2 diabetes mellitus in Vietnam (DiabCare Asia). International Journal of Diabetes in Developing Countries, 2019. 40.
9. Liu, Y.P., et al., Determinants of arterial properties in Chinese type-2 diabetic patients compared with population-based controls. Acta Cardiol, 2011. 66(5): p. 619-26.
10. Chang, S., et al., Effects of glucose control on arterial stiffness in patients with type 2 diabetes mellitus and hypertension: An observational study. J Int Med Res, 2018. 46(1): p. 284-292.
11. Blacher, J., et al., Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension, 1999. 33(5): p. 1111-7.
12. Cao Truong Sinh and Nguyen Thi Nga, Assessment of the ankle-brachial index and pulse wave velocity in patients with type 2 diabetes and hypertension. 2020. 27.
13. Katakami, N.J.J.o.a. and thrombosis, Mechanism of development of atherosclerosis and cardiovascular disease in diabetes mellitus. 2018. 25(1): p. 27-39.
14. Sjöblom, P., et al., Microalbuminuria, but not reduced eGFR, is associated with cardiovascular subclinical organ damage in type 2 diabetes. Diabetes Metab, 2014. 40(1): p. 49-55.
