CAROTID DISTENSIBILITY VARIES ACCORDING TO GLYCEMIC STATUS IN INDIVIDUALS WITH TREATED HYPERTENSION

Objective: Hypertension and diabetes independently increase arterial stiffness. Carotid Distensibility, Pulse Wave Velocity (PWV), and the Ambulatory Arterial Stiffness Index (AASI) provide complementary measures of vascular stiffness, but their respective role in patients with hypertension and diabetes remains underexplored. We studied the association of arterial stiffness evaluated by each one of the tree methods with blood pressure (BP) and glycemic status.Design and method: We recruited outpatients with hypertension, who were standardized to receive the same antihypertensive treatment for one month: Hydrochlorothiazide 25 mg/day and Enalapril 40 mg/day or Losartan (100 mg/day) in case of enalapril intolerance. Assessments included 24-hour ABPM; Carotid Distensibility (Wall Track System); and PWV measurement (Complior). AASI was calculated from 24-hour ABPM and Carotid Distensibility was measured as the percentual variation of diameter during systole. Linear regression models were used to establish the association between predictors (awake systolic BP, sleep systolic BP, fasting glycemia, and DM2) and outcomes (PWV, AASI, and Carotid Distensibility). Standardized coefficients (beta weights) with 95% confidence intervals were reported in unadjusted models and models adjusted for sex and age. Results: The study sample comprised 48 individuals (mean age: 54±8 years; 71% female; 31.3% with diabetes). No significant diferences were observed in age, sex, or office and ambulatory BP between participants with and without diabetes. Figure 1 shows the unadjusted and adjusted association between predictors and arterial stiffness measurements. In regression models adjusted for sex and age, both fasting glycemia (beta -0.391, 95% CI -0.658 to -0.123, p=0.005) and presence of DM2 (beta -0.742, 95% CI -1.325 to -0.158, p=0.014) were inversely associated with Carotid Distensibility, but not with PWV (p=0.919) or AASI (p=0.107). Conversely, awake BP was associated with PWV (beta 0.327, 95% CI 0.055 to 0.599, p=0.020) and AASI (beta 0.396, 95% CI 0.120 to 0.671, p=0.006), but not with Carotid Distensibility (beta 0.068, 95% CI -0.249 to 0.384, p=0.668). Conclusions: In this sample of patients on a uniform antihypertensive regimen, Carotid Distensibility was more sensitive to glycemic status than to BP, contrasting with PWV and AASI, which reflected blood pressure variations.