ARTERIAL INFLAMMATION, BLOOD PRESSURE AND CENTRAL HEMODYNAMICS – THE ABC OF DIABETIC ANGIOPATHY

• Main Author: Simone Theilade
• Format: Article
• Language: English
• Published: Atlantis Press 2016-11-01
• Series: Artery Research
• Online Access: https://www.atlantis-press.com/article/125930376/view

Aim: In diabetes patients, we explored relationships between markers of diabetic angiopathy, diabetic complications and adverse outcome. Methods: Patients were recruited from 3 observational studies from Steno Diabetes Center, Denmark and one randomized, double-blind, international, multicentre study. We investigated inflammatory proteins, blood pressure (BP) and central hemodynamics as markers of diabetic angiopathy. Inflammatory proteins were soluble urokinase plasminogen activator receptor and placental growth factor, measured from frozen blood samples (suPARnostic®, ViroGates, Denmark and Elecsys®, Roche, Germany). Sphygmomanometry and/or tonometry measured BPs. PWV and PWA recordings were obtained with SphygmoCor (Atcor, Sydney, Australia) and Bpro (HealthStats, Singapore) (only PWA). PWA recordings included central BPs, augmentation pressure, augmentation index and subendocardial viability ratio. Results: We demonstrated increased arterial inflammation and arterial stiffness, and altered central hemodynamics in diabetes. These changes were augmented with longer diabetes duration. Furthermore, diabetic angiopathy measures were related to diabetic complications and predictive of adverse outcome. We demonstrated significant discrepancies between office and 24-hour BPs, documenting considerable undertreatment of patients and a substantiated need for 24-hour BP recordings. We demonstrated significant differences in central and brachial BPs, and proposed reference values for central BP in diabetes patients. Conclusions: Our data show added diagnostic and prognostic value of measurements of diabetic angiopathy evaluated as measures of arterial inflammation, 24-hour ambulatory BP, central BP, arterial stiffness and pulse wave reflection. Perspectives: Evaluating markers of diabetic angiopathy, may help identify patients at higher risk for development of diabetic complications. These patients may be suited for advanced and earlier medical treatment.