Sex Differences in Age-Related Stiffening of the Aorta in Subjects With Type 2 Diabetes

Abstract

Hypertension and type 2 diabetes are associated with increased aortic pulse wave velocity (PWV), a measure of aortic stiffness and a powerful risk factor for cardiovascular events. The association of hypertension with type 2 diabetes may obscure the degree to which diabetes rather than hypertension contributes to an elevated PWV. The objective of this study was to determine whether the presence of type 2 diabetes is associated with an elevated PWV compared with nondiabetic subjects matched for mean arterial blood pressure. PWV was determined by measuring carotid to femoral transit time using applanation tonometry in 186 subjects (104 women) with (n=93) and without (n=93) type 2 diabetes. Diabetic and nondiabetic subjects were matched for age and mean arterial pressure (to ±5 years and 5 mm Hg, respectively). PWV was strongly correlated with age and mean arterial blood pressure ( R =0.59 and 0.29 respectively, each P −1 · year ⁻¹ ) than in nondiabetic women (0.08±0.02 m · s ⁻¹ · year ⁻¹ , P −1 · year ⁻¹ ) and nondiabetic subjects (0.13±0.03 m · s ⁻¹ · year ⁻¹ , P=NS). The interaction of diabetic status with age and with sex was significant ( P =0.01). Type 2 diabetes is associated with a greater age-related stiffening of the aorta in women compared with men, and this is not explained by hypertension.