Background:
Hypertension is associated with increased aortic stiffness, a marker of cardiovascular disease. Large artery stiffness is accelerated in persons with diabetes. While increased fitness and reduced fatness are associated with lower BP, the relationships of fitness, abdominal obesity, and BP with aortic stiffness are less clear.
Purpose:
To examine relationships among fitness, abdominal obesity, BP, and aortic stiffness in persons with type 2 diabetes and hypertension
Methods:
51 sedentary subjects (M = 41; F = 18) aged 56.5 +/- 5.8 years were examined at baseline as part of an exercise training study to reduce BP in persons with type 2 diabetes. Subjects were taking their usual medical therapy. For BP eligibility, subjects were required to have SBP between 120-159 and/or DBP between 80-99 mm Hg during 2 consecutive weekly visits. BP was the mean of the screening visits and a visit after qualification for the study. Aortic stiffness was assessed by carotid-to-femoral pulse wave velocity (PWV), using ultrasound probes simultaneously at each of these sites. Abdominal obesity was assessed by magnetic resonance imaging at the level of the umbilicus and the areas for total, subcutaneous, and visceral fat were measured. Maximal oxygen uptake was obtained on a treadmill. The associations of PWV with BP, pulse pressure (PP), oxygen uptake, and abdominal fat were determined by stepwise regression analysis.
Results:
SBP was 130.1 +/- 10.5, DBP was 74.2 +/- 8.1, and PP was 56.1 +/- 9.9 mm Hg. The mean PWV was 983.3 +/- 319.0 msec. Maximal oxygen uptake was 21.9 +/- 5.3 ml/kg/min. In the regression analysis, PP explained 12.4% of the variance in PWV, abdominal visceral fat explained an additional 7.1%, and abdominal subcutaneous fat explained an additional 5.8%. SBP, DBP, and maximal oxygen uptake did not provide an independent contribution to the explanation of PWV.
Conclusions:
These results confirm the established association of a higher PP with greater aortic stiffness. The novel finding herein is the association of higher accumulations of abdominal fat with greater aortic stiffness. While controlling BP is an established a goal for persons with diabetes, the present data suggest that reducing abdominal obesity may also be important for improving cardiovascular health.