Aim of the study was to evaluate the impact of diabetes, hypertension, and their combination on aortic, carotid and peripheral stiffening.

139 subjects (31 normotensives-NT, 38 hypertensives-HT, 24 diabetic normotensives-DMNT, and 46 diabetic hypertensives-DMHT) were enrolled. Applanation tonometry (Sphygmocor) was used to measure aortic (carotid to femoral) and peripheral (carotid to radial) pulse wave velocity (aPWV and pPWV respectively). Common carotid stiffness (CS) was determined using the real-time computerized echo-tracking system “Carotid Studio”.

pPWV was similar in the four groups. aPWV significantly increased from NT (7.3±1.1m/s) to HT (8.2±1.4 m/s) and DMNT (8.3±1.3 m/s), reaching the highest value in the DMHT group (10.8±1.9 m/s). CS was similar in NT (6.1±0.8m/s) and DMNT (6.4±1.1 m/s), and significantly increased in HT and DMHT (6.7±1.2m/s, 7.4±1.2m/s).

In a model adjusted for age, gender and diabetes, the presence of hypertension carried a 5.6-fold (confidence interval-95% 1.9–16.5) increased risk of having aPWV above the median value of 8.5 m/s, and a 4.5–fold (1.7–11.9) increased risk of having CS (above median value of 6.6 m/s). The presence of diabetes carried a 7.2-fold (2.8–18.9) increased risk of having increased aPWV, while the analysis was not significant for carotid stiffness (OR 2.1, 0.9–4.7).

In conclusion, increased aPWV is present in both diabetic and hypertensive patients, and the combination of the two risk factors induces an even greater aortic stiffening. While hypertension is characterized by vascular stiffening at both the aortic and carotid level, carotid stiffening in diabetic patients appears to be mostly dependent on the concomitant presence of hypertension.