P3.17 EFFECT OF HYPERTENSION ON ARTERIAL STIFFNESS IN GHANAIAN SUBJECTS WITH TYPE 2 DIABETES

Abstract

Background: Hypertension exacerbates cardiovascular disease in type 2 diabetes (T2DM) but the ACCORD trial suggested limited impact on CVS events by hypertensive treatment. Our hypothesis is that arterial stiffness, measured as aortic pulse wave velocity (PWV) may underlie these events. Few data exist on arterial stiffness in hypertensive diabetes patients in sub-Saharan Africa, where the two conditions are becoming epidemic. We compared indices of arterial stiffness in T2DM subjects with (T2DM+HT), without (T2DM-HT) hypertension and normotensive non-diabetes (NDM). Methods: Forty eight T2DM+HT, 45 T2DM-HT and 34 NDM volunteers (as screened by OGTT), between the ages of 40–70 years, were randomly recruited. Weight, height and waist circumference (WC) were measured. Indices of arterial stiffness, pulse wave velocity (PWV), aortic systolic blood pressure (aSBP), and aortic augmentation index(aAlx) were measured with Arteriograph (Tensiomed, Hungary) and Cardio-Ankle Vascular Index (CAVI) with Vasera 1500 (Fukuda-Denshi, Tokyo, Japan) in supine subjects after 10 minutes rest in a temperature controlled room. Results: In a univariate analysis, after adjusting for gender, age in decade, BMI and waist circumference, mean values of CAVI (8.43±1.31 vs. 7.4±1.05 vs. 7.00±0.87; p<0.001), PWV (9.16±1.04 vs. 7.98±1.28 vs. 7.64±1.42; p<0.001), aSBP (153.94±25.62 vs. 115.72±11.11 vs. 117.06±11.11; p<0.001) and aAIx (28.53±12.43 vs. 19.18±11.47 vs. 26.21±14.08; p=0.026) were higher in T2DM+HT than T2DM-HT, which was also higher than NDM. Contrast analysis showed no significant difference between aSBP between T2DM-HT and NDM. Conclusion: Hypertension increases arterial stiffness in T2DM subjects in Ghana.