P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY
Introduction: Arterial remodeling is an adaptive phenomenon aimed at maintaining circumferential wall stress (CWS) within operating limits. It is characterized by widening of the inter-adventitial diameter (IAD) and increases in intima-media thickness (IMT). This process is maladaptive when CWS incr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2015-11-01
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| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125930613/view |
| _version_ | 1828395228863660032 |
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| author | Veronica Onete* Ronald Henry Miranda Schram Jacqueline Dekker Giel Nijpels Coen Stehouwer |
| author_facet | Veronica Onete* Ronald Henry Miranda Schram Jacqueline Dekker Giel Nijpels Coen Stehouwer |
| author_sort | Veronica Onete* |
| collection | DOAJ |
| description | Introduction: Arterial remodeling is an adaptive phenomenon aimed at maintaining circumferential wall stress (CWS) within operating limits. It is characterized by widening of the inter-adventitial diameter (IAD) and increases in intima-media thickness (IMT). This process is maladaptive when CWS increases despite remodeling. Type 2 Diabetes (T2D) is associated with increased carotid CWS, but its association with cardiovascular disease (CVD) is unknown.
Methods: The cohort consisted of 277 individuals with normal glucose metabolism (NGM), 162 with impaired glucose metabolism (IGM) and 131 with T2D (age 69.6 ± 6.4, 51.0% women, systolic pressure 141.9 ± 20.6 mmHg, bmi 26.9 ± 3.5 kg/m2, prior CVD 50.1%). Carotid arterial properties (IAD, IMT, lumen diameter (LD)) were quantified by ultrasonography. CWS was calculated as PP·LD/(2IMT), where PP is the brachial pulse pressure. A morbidity and mortality register was kept on all individuals.
Results: After a median of 7.7 [IQR 7.0-8.1] years of follow up, 130 CVD events and 93 deaths were recorded. CWS was 31.7, 31.5 and 34.4 kPa in NGM, IGM and T2D, respectively (Ptrend= 0.06). Greater CWS was associated with incident CVD in T2D only (hazard ratio(95%CI) per SD increase in CWS for NGM: 0.92 (0.70–1.21); IGM: 1.02 (0.66–1.58) and T2D 1.52 (1.09–2.14), after adjustment for age, sex, height and other CVD risk factors.. No associations were observed between CWS and all-cause mortality.
Conclusion: T2D is associated with greater CWS compared to NGM and IGM. Greater carotid CWS is associated with incident CVD in T2D but not in NGM or IGM. |
| first_indexed | 2024-12-10T08:09:10Z |
| format | Article |
| id | doaj.art-a8c2b21f3db54c72977daf6e1c780ba2 |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-12-10T08:09:10Z |
| publishDate | 2015-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-a8c2b21f3db54c72977daf6e1c780ba22022-12-22T01:56:37ZengBMCArtery Research1876-44012015-11-011210.1016/j.artres.2015.10.250P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDYVeronica Onete*Ronald HenryMiranda SchramJacqueline DekkerGiel NijpelsCoen StehouwerIntroduction: Arterial remodeling is an adaptive phenomenon aimed at maintaining circumferential wall stress (CWS) within operating limits. It is characterized by widening of the inter-adventitial diameter (IAD) and increases in intima-media thickness (IMT). This process is maladaptive when CWS increases despite remodeling. Type 2 Diabetes (T2D) is associated with increased carotid CWS, but its association with cardiovascular disease (CVD) is unknown. Methods: The cohort consisted of 277 individuals with normal glucose metabolism (NGM), 162 with impaired glucose metabolism (IGM) and 131 with T2D (age 69.6 ± 6.4, 51.0% women, systolic pressure 141.9 ± 20.6 mmHg, bmi 26.9 ± 3.5 kg/m2, prior CVD 50.1%). Carotid arterial properties (IAD, IMT, lumen diameter (LD)) were quantified by ultrasonography. CWS was calculated as PP·LD/(2IMT), where PP is the brachial pulse pressure. A morbidity and mortality register was kept on all individuals. Results: After a median of 7.7 [IQR 7.0-8.1] years of follow up, 130 CVD events and 93 deaths were recorded. CWS was 31.7, 31.5 and 34.4 kPa in NGM, IGM and T2D, respectively (Ptrend= 0.06). Greater CWS was associated with incident CVD in T2D only (hazard ratio(95%CI) per SD increase in CWS for NGM: 0.92 (0.70–1.21); IGM: 1.02 (0.66–1.58) and T2D 1.52 (1.09–2.14), after adjustment for age, sex, height and other CVD risk factors.. No associations were observed between CWS and all-cause mortality. Conclusion: T2D is associated with greater CWS compared to NGM and IGM. Greater carotid CWS is associated with incident CVD in T2D but not in NGM or IGM.https://www.atlantis-press.com/article/125930613/view |
| spellingShingle | Veronica Onete* Ronald Henry Miranda Schram Jacqueline Dekker Giel Nijpels Coen Stehouwer P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY Artery Research |
| title | P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY |
| title_full | P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY |
| title_fullStr | P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY |
| title_full_unstemmed | P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY |
| title_short | P4.6 GREATER CAROTID CIRCUMFERENTIAL WALL STRESS IS ASSOCIATED WITH INCIDENT CARDIOVASCULAR DISEASE IN INDIVIDUALS WITH TYPE 2 DIABETES – THE HOORN STUDY |
| title_sort | p4 6 greater carotid circumferential wall stress is associated with incident cardiovascular disease in individuals with type 2 diabetes the hoorn study |
| url | https://www.atlantis-press.com/article/125930613/view |
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