Dependency between local carotid arterial stiffness and the presence of atherosclerotic plaque in the carotid basin in hypertensive patients with type 2 diabetes mellitus

Authors

DOI:

https://doi.org/10.14739/2310-1210.2024.2.296602

Keywords:

diabetes mellitus, hypertension, arterial stiffness, atherosclerotic plaque

Abstract

Aim. To assess the impact of atherosclerotic plaque (ASP) on the local arterial stiffness of the common carotid arteries (CCA) in patients with stage II hypertension (HTN) in combination with type 2 diabetes mellitus (T2DM).

Materials and methods. The study included 37 patients with stage II HTN and T2DM (mean age 60.4 ± 10.7; 66.7 % male). Patients were divided into two groups: 20 individuals with ASP and <50 % stenosis in the carotid basin, 17 without ASP. The study involved a clinical examination, body weight and percentage of adipose tissue (AT) measurements, analysis of lipid and carbohydrate metabolism laboratory parameters, echocardiography, CCA ultrasound examination with the determination of local stiffness and intima-media complex thickness (IMT). Statistical analysis was performed, significant differences were considered at p < 0.05.

Results. The whole-body AT percentage <39.51 % increases the odds ratio (OR) of ASP by 6 times (p = 0.02), an exceeding compliance coefficient (CC) over 0.68 mm2/kPa – by 12.7 times (p = 0.02), right CCA-IMT of over 639 µm – by 1.012 times (p = 0.001), and the factors are mutually reinforcing in the multivariate models and independent of age, sex, body mass index, and glycated hemoglobin level. Ascending aorta dilatation of over 3.34 cm increases the OR of ASP by 11.6 times (p = 0.0107); the factor is enhanced after adjusting for elevated total cholesterol levels over >6.35 mmol/l (p = 0.036) and independent of age and sex. A greater left CCA diameter of more than 8.59 mm (p < 0.019) and right CCA diameter of more than 8.1 mm (p < 0.0001) increases the OR of ASP by 3.7 times (p = 0.001) and 6.6 times (p = 0.0013), respectively, the factor influence increases after adjusting for elevated total cholesterol levels over >6.35 mmol/l (p = 0.031) and it is also unaffected by age and sex.

Conclusions. In individuals with stage II HTN and T2DM, the presence of CA atherosclerosis with stenosis up to 50 % is associated with a significantly increased CCA and ascending aorta diameter, a decreased percentage of AT, and an increased compliance coefficient of plaque-free wall segments.

Author Biographies

V. V. Syvolap, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, DSc, Professor of the Department of Propaedeutics of Internal Medicine, Radiation Diagnostics and Radiation Therapy

A. O. Bohun, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, Postgraduate student of the Department of Propaedeutics of Internal Medicine, Radiation Diagnostics and Radiation Therapy

References

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843. doi: https://doi.org/10.1016/j.diabres.2019.107843

Yang X, Chen J, Pan A, Wu JHY, Zhao F, Xie Y, et al. Association between Higher Blood Pressure and Risk of Diabetes Mellitus in Middle-Aged and Elderly Chinese Adults. Diabetes Metab J. 2020;44(3):436-45. doi: https://doi.org/10.4093/dmj.2019.0081

Gajdova J, Karasek D, Goldmannova D, Krystynik O, Schovanek J, Vaverkova H, et al. Pulse wave analysis and diabetes mellitus. A systematic review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017;161(3):223-33. doi: https://doi.org/10.5507/bp.2017.028

Tian X, Zuo Y, Chen S, Zhang Y, Zhang X, Xu Q, et al. Hypertension, Arterial Stiffness, and Diabetes: a Prospective Cohort Study. Hypertension. 2022;79(7):1487-96. doi: https://doi.org/10.1161/HYPERTENSIONAHA.122.19256

Ekambarapu L, Bolaji O, Nguyen JD, Bilchick K, Kwon Y, Breathett K, et al. Estimated pulse wave velocity in heart failure with preserved ejection fraction is associated with adverse outcomes: A post hoc analysis of the TOPCAT trial. Journal of Cardiac Failure. 2024;30(1): 207-7. doi: https://doi.org/10.1016/j.cardfail.2023.10.219

Liao M, Chen S, Guo R. Association between carotid ultrasonographic parameters and microvascular and macrovascular complications in diabetes: A systematic review and meta-analysis. J Diabetes Complications. 2023;37(8):108554. doi: https://doi.org/10.1016/j.jdiacomp.2023.108554

Tanaka T, Kishi S, Ninomiya K, Tomii D, Koseki K, Sato Y, et al. Impact of abdominal fat distribution, visceral fat, and subcutaneous fat on coronary plaque scores assessed by 320-row computed tomography coronary angiography. Atherosclerosis. 2019;287:155-61. doi: https://doi.org/10.1016/j.atherosclerosis.2019.06.910

Ferreira J, Cunha P, Carneiro A, Vila I, Cunha C, Silva C, et al. Is Obesity a Risk Factor for Carotid Atherosclerotic Disease?-Opportunistic Review. J Cardiovasc Dev Dis. 2022;9(5):162. doi: https://doi.org/10.3390/jcdd9050162

Imahori Y, Mathiesen EB, Morgan KE, Frost C, Hughes AD, Hopstock LA, et al. The association between anthropometric measures of adiposity and the progression of carotid atherosclerosis. BMC Cardiovasc Disord. 2020;20(1):138. doi: https://doi.org/10.1186/s12872-020-01417-0

See R, Abdullah SM, McGuire DK, Khera A, Patel MJ, Lindsey JB, et al. The association of differing measures of overweight and obesity with prevalent atherosclerosis: the Dallas Heart Study. J Am Coll Cardiol. 2007;50(8):752-9. doi: https://doi.org/10.1016/j.jacc.2007.04.066

Bohun AO. [Dependence of local carotid arterial stiffness on the presence of atherosclerotic plaque in the carotid basin in hypertensive patients]. Zaporozhye medical journal. 2024;26(1):11-8. Ukrainian. doi: https://doi.org/10.14739/2310-1210.2024.1.293501

Syvolap VV, Bohun AO. [Association of left ventricular diastolic function with parameters of arterial stiffness and atherosclerotic plaques in the carotid basin in hypertensive patients]. Modern medical technology. 2024;16(1):5-13. Ukrainian. doi: https://doi.org/10.14739/mmt.2024.1.298494

Safar ME, Asmar R, Benetos A, Blacher J, Boutouyrie P, Lacolley P, et al. Interaction Between Hypertension and Arterial Stiffness. Hypertension. 2018;72(4):796-805. doi: https://doi.org/10.1161/HYPERTENSIONAHA.118.11212

Wang Z, Zhang M, Zhang Y, Shen H, Dai X, Chen L, et al. The study of carotid atherosclerosis plaque biomechanics patients with metabolic syndrome using multiple tracking techniques. Heart. 2012;98(Suppl 2):E26.1-E26. doi: https://doi.org/10.1136/heartjnl-2012-302920a.57

Paini A, Boutouyrie P, Calvet D, Zidi M, Agabiti-Rosei E, Laurent S. Multiaxial mechanical characteristics of carotid plaque: analysis by multiarray echotracking system. Stroke. 2007;38(1):117-23. doi: https://doi.org/10.1161/01.STR.0000251796.38954.b2

Mackey RH, Venkitachalam L, Sutton-Tyrrell K. Calcifications, arterial stiffness and atherosclerosis. Adv Cardiol. 2007;44:234-44. doi: https://doi.org/10.1159/000096744

Ahmadizar F, Wang K, Roos M, Bos M, Mattace-Raso F, Kavousi M. Association between arterial stiffness/remodeling and new-onset type 2 diabetes mellitus in general population. Diabetes Res Clin Pract. 2023;196:110237. doi: https://doi.org/10.1016/j.diabres.2023.110237

Sharif S, Visseren FL, Spiering W, de Jong PA, Bots ML, Westerink J, et al. Arterial stiffness as a risk factor for cardiovascular events and all-cause mortality in people with Type 2 diabetes. Diabet Med. 2019;36(9):1125-32. doi: https://doi.org/10.1111/dme.13954

Wei Y, Wang M, Gui Y, Piao X, Sun C, Zhang X, et al. Carotid artery stiffness in rural adult Chinese: a cross-sectional analysis of the community-based China stroke cohort study. BMJ Open. 2020;10(10):e036398. doi: https://doi.org/10.1136/bmjopen-2019-036398

Wei LM, Zhu YQ, Bao YQ, Lu HT, Zhang PL, Zhao YW, et al. Atherosclerosis in intracranial or extracranial vessels in diabetic patients and the association with stroke subtype. Quant Imaging Med Surg. 2019;9(6):960-7. doi: https://doi.org/10.21037/qims.2019.04.17

Hoke M, Schillinger M, Minar E, Goliasch G, Binder CJ, Mayer FJ. Carotid ultrasound investigation as a prognostic tool for patients with diabetes mellitus. Cardiovasc Diabetol. 2019;18(1):90. doi: https://doi.org/10.1186/s12933-019-0895-0

Dimic A, Markovic M, Vasic D, Dragas M, Zlatanovic P, Mitrovic A, et al. Impact of diabetes mellitus on early outcome of carotid endarterectomy. Vasa. 2019;48(2):148-56. doi: https://doi.org/10.1024/0301-1526/a000737

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Published

2024-03-29

How to Cite

1.
Syvolap VV, Bohun AO. Dependency between local carotid arterial stiffness and the presence of atherosclerotic plaque in the carotid basin in hypertensive patients with type 2 diabetes mellitus. Zaporozhye Medical Journal [Internet]. 2024Mar.29 [cited 2024Nov.27];26(2):93-100. Available from: http://zmj.zsmu.edu.ua/article/view/296602

Issue

Vol. 26 No. 2 (2024): Zaporozhye medical journal

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Original research

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