Adverse effect of diabetes and hyperglycaemia on arterial stiffness in Europeans, South Asians, and African Caribbeans in the SABRE study

作者：Park Chloe M^*; Tillin Therese; March Katherine; Jones Siana; Whincup Peter H; Mayet Jamil; Chaturvedi Nish; Hughes Alun D

来源：Journal of Hypertension, 2016, 34(2): 282-289.

DOI：10.1097/HJH.0000000000000789

• arterial stiffness
• blood pressure
• diabetes
• ethnicity
• haemodynamics
• hyperglycaemia

Objectives:Ethnic minority groups in the UK experience marked differences in cardiovascular disease risk. We investigated differences in arterial central haemodynamics, stiffness, and load in a tri-ethnic population-based cohort.Methods:A total of 1312 participants (706 years) underwent echocardiography and measurement of brachial and central blood pressure to assess central arterial haemodynamics including central pulse pressure (cPP), arterial stiffness [cPP/stroke volume (SV)], systemic vascular resistance (SVR), and load (E-a).Results:Brachial and central SBPs were similar in all ethnic groups. Compared with Europeans, cPP, cPP/SV, and E-a were higher in South Asians. In contrast, cPP/SV was lower in African Caribbeans despite higher mean arterial pressure, higher SVR, and higher diabetes prevalence. cPP/SV and E-a remained significantly higher in South Asians and significantly lower in African Caribbeans after multivariate adjustment. Diabetes and higher HbA(1c) were more strongly associated with higher cPP/SV in South Asians than in Europeans (P-interaction=0.045 and 0.005, respectively); higher HbA(1c) was also more strongly associated with increased E-a in South Asians than Europeans (P-interaction=0.01). There was no evidence of an interaction between glycaemia and cPP/SV in African Caribbeans.Conclusions:Compared with Europeans, South Asians have unfavorable arterial function. Diabetes and hyperglycaemia have a more deleterious effect on cPP/SV and E-a in South Asians. In contrast, African Caribbeans have more favourable arterial function than Europeans and South Asians. These differences may contribute to the differential ethnic rates of cardiovascular disease.

• 出版日期2016-2