Increased arterial stiffness elevates the risk of heart failure in diabetic patients

https://doi.org/10.1016/j.ijcard.2023.05.039Get rights and content
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Highlights

  • AS was an independent risk factor for developing HF in the diabetic population.

  • AS exhibits a dose-response relationship with HF risk.

Abstract

Background

Previous studies have shown that arterial stiffness (AS) was a risk factor for heart failure (HF) in nondiabetic patients. We aimed to analyze this impact in a community-based diabetic population.

Methods

Our study excluded those who had HF before brachial-ankle pulse wave velocity (baPWV) measurement and included 9041 participants finally. Subjects were divided into the normal (<14 m/s), intermediate (14–18 m/s), and elevated baPWV groups (>18 m/s) based on baPWV values. Multivariate Cox proportional hazard model was used to analyze the effect of AS on HF risk.

Results

During the median follow-up of 4.19 years, 213 patients had HF. The results of Cox model showed that HF risk in the elevated baPWV group was 2.25 times higher than that in the normal baPWV group (95% confidence interval [CI]: 1.24–4.11). HF risk increased by 18% (95% CI:1.03–1.35) for every 1 additional standard deviation(SD)of baPWV. Restricted cubic spline results showed statistically significant overall and non-linear associations between AS and HF risk (P < 0.05). The subgroup analysis and sensitivity analysis were consistent with that of total population.

Conclusions

AS is an independent risk factor for developing HF in the diabetic population, and AS exhibits a dose-response relationship with HF risk.

Keywords

Arterial stiffness
Heart failure
Diabetes mellitus
Prospective study

Abbreviations

AS
arterial stiffness
HF
heart failure
CI
Confidence interval
SD
standard deviation
baPWV
brachial-ankle pulse wave velocity
MI
myocardial infarction
AF
atrial fibrillation
CKD
chronic kidney disease
BMI
Body mass index
SBP
Systolic blood pressure
DBP
Diastolic blood pressure
FBG
Fasting blood glucose
TC
Total cholesterol
TG
Triglycerides
LDL-C
Low-density lipoprotein cholesterol
HDL-C
How-density lipoprotein cholesterol
hsCRP
hypersensitive C-reactive protein
eGFR
Estimated glomerular filtration rate
HR
Hazard ratio

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1

All above mentioned authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.