Study of Vascular and Endothelial Function in Type II Diabetes with Newly Diagnosed

Abstract

BackgroundHigh risk of cardiovascular and cerebrovascular diseases are associated with diabetes and this risk is augmented with coexistent hypertension. Increased arterial stiffness and endothelial dysfunction are independent risk factors and predictor of adverse cardiovascular outcome. Angiotensin converting enzyme inhibitors (ACE inhibitors) have been prescribed for the hypertension treatment and are known to reduce cardiovascular mortality and morbidity.ObjectiveTo study the effect of ACE inhibitor on vascular and endothelial function in type 2 diabetes with newly diagnosed hypertension.MethodsSixty‐five diabetic patients with newly diagnosed hypertension with the mean age of 48 ± 6.5 years were enrolled in the study. The mean duration of diabetes and BMI was 6.01 ± 5.03 years and 28.18 ± 4.23 kg/m2, respectively. Arterial stiffness was assessed using Augmentation index (AIx@75) and Pulse Wave Velocity (PWV) [carotid‐radial (cr), and carotid‐femoral (cf)] by applanation tonometry using SphygmocorR. Endothelial function was assessed by flow mediated dilatation (FMD) using B‐mode vascular ultrasound. All the recordings were done at baseline, after 1 week and after 3 Months of ACE inhibition.ResultsBoth Peripheral and central blood pressures (systolic, diastolic and pulse pressure) were reduced significantly after ACE inhibition (p <0.0001). There was significant reduction in AIx@75 after 1 week of ACE inhibitor treatment as compared to baseline (25.86 ± 10.01 vs 20.85 ± 10.06 %, p<0.0001). cr and cf PWV were significantly decreased from baseline to after 1 week of treatment [9.15 ± 1.64 Vs 8.32 ± 1.52 m/s (p<0.0001) and 11.3 ± 2.84 Vs 10.38 ± 3.08 m/s (p<0.05) respectively] and from baseline to after 3 months of ACE inhibitor treatment [9.15 ± 1.64 Vs 8.16 ± 1.53 m/s, (p<0.0001) and 11.3 ± 2.84 Vs 9.78 ± 2.98 m/s (p=0.0002), respectively]. Similarly, FMD was significantly increased after 1 week and 3 months of ACE inhibition as compared to baseline [6.1 ± 3.2 Vs 8 ± 3.11%, and 6.29 ± 3.27 Vs 9.99 ± 3.17% (p<0.0001)]. There was further improvement in FMD from 1 week to 3 months of ACE inhibition [8 ± 3.11 Vs 9.99 ± 3.17% (p<0.0001)].ConclusionBoth arterial stiffness, including central pressures and endothelial function improved within 1 week of ACE inhibition. Endothelial function further improved after 3 months of ACE inhibition in type II diabetic patients with newly diagnosed hypertension. This could be because of ACE inhibitor mitigates the effect of angiotensin II on endothelium and vascular smooth muscles.Support or Funding InformationAll India Institute of Medical Sciences, New Delhi, India.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.