Diabetes, A1c, Hypertension Link With Arterial Stiffness

Abdullah Hashmi, MD, for Medscape

February 07, 2022

The study covered in this summary was published on medRxiv as a preprint and has not yet been peer-reviewed.

Key Takeaway

  • Diabetes, an A1c level of at least 5.7%, and hypertension were significantly associated with increased arterial stiffness as measured by aortic pulse wave velocity (PWV).

Why This Matters

  • Although diabetes is an independent predictor for cardiovascular adverse events, the mechanism of action linking diabetes with cardiovascular risk is not fully understood. The data suggest that arterial stiffness as assessed by pulse wave links the presence of diabetes with increased cardiovascular risk.

  • The authors said their findings could be relevant to patients in medical clinics and when receiving health services.

Study Design

  • The study used data from an observational, cross-sectional cohort of 1197 patients from BioCor Cardiology Center in Maringá, Brazil who underwent noninvasive measurement of PWV and central blood pressure from 2010-2016.

  • The researchers analyzed the association of several dichotomized variables with an elevated PWV of at least 10 m/s. They divided values for A1c into three groups: <5.7%, ≥5.7%–6.4%, or ≥6.5%.

  • The dichotomized determinations were presence of diabetes (yes/no), systemic arterial hypertension (yes/no), total cholesterol (<190, ≥190 mg/dL), low-density lipoprotein cholesterol (LDLc; <130, ≥130 mg/dL), high-density lipoprotein cholesterol (HDLc; <40, ≥40 mg/dL), and triglycerides (<150, ≥150 mg/dL).

Key Results

  • Among the 1197 patients with available data, 341 (28.5%) had altered PWV, and 856 (71.5%) did not have altered PWV. 

  • A logistical regression analysis estimated the association of independent variables with PWV ≥10 as the outcome variable. Positive associations linked elevated PWV with the presence of diabetes (odds ratio [OR], 1.5; P = .04), hypertension (OR, 2.7; P < .001), A1c 5.7%–6.4% (OR, 2.1, P < .001), A1c ≥6.5% (OR 3.6; P < .001), and HDLc ≤40 mg/dL (OR, 1.4; P = .031). The analysis adjusted for diabetes, hypertension, A1c, total cholesterol, LDLc, HDLc, and triglycerides.


  • Although 1197 patients were included, a larger sample would provide greater precision, especially with diabetes as a predictor.

  • PWV assessment is difficult and, in this study, occurred at a single center over a 7-year period.


  • The authors had no disclosures.

  • The authors received no financial support for the research, authorship, or publication of the article.

This is a summary of a preprint research study, "Diabetes mellitus, hypertension, and HbA1c, as risk factors for arterial stiffness," written by researchers at the State University of Maringá, Brazil on medRxiv, provided to you by Medscape. This study has not yet been peer-reviewed. The full text of this study can be found on medRxiv.org.

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