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Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients.
J Hypertens. 2012 May; 30(5):940-7.JH

Abstract

OBJECTIVE

Factors associated with carotid atherosclerosis are unclear in type 2 diabetic patients. The aim was to investigate the independent correlates of carotid intima-media thickness (IMT) and plaques in these individuals.

METHODS

In a cross-sectional study, we measured carotid IMT at three sites (common carotid, bifurcation and internal carotid artery) and the severity of extracranial carotid artery (ECCA) atherosclerosis by plaque score in 441 type 2 diabetic patients. Nontraditional cardiovascular risk factors [ambulatory blood pressures (BPs), aortic stiffness, C-reactive protein and ankle-brachial index) were obtained. Multivariate linear and logistic regressions assessed the independent correlates of carotid IMT and ECCA plaque score.

RESULTS

Patients with greater carotid IMT or plaque scores had worse clinical and laboratory profile than those with lower IMT and plaque scores, including higher BPs, aortic stiffness and prevalences of diabetic complications. On multivariate analysis, carotid IMT and plaques were mainly associated with older age, male sex, current-past smoking and ambulatory BPs, but not with clinic BPs. Night-time pulse pressure was the most important modifiable determinant of increased carotid IMT. No microvascular complication was independently associated with carotid atherosclerosis, except retinopathy for plaque score. Additionally, internal carotid IMT and plaque score were associated with ankle-brachial index in the subgroup of patients without macrovascular diseases.

CONCLUSION

In type 2 diabetic patients, older age, male sex, smoking status and ambulatory BPs, particularly night-time pulse pressure, were the main independent correlates of ultrasonographic carotid atherosclerosis. This finding reinforces the importance of ambulatory BP monitoring in type 2 diabetes management.

Authors+Show Affiliations

Department of Internal Medicine, University Hospital Clementino Fraga Filho, Medical School, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22495135

Citation

Cardoso, Claudia R L., et al. "Factors Associated With Carotid Intima-media Thickness and Carotid Plaques in Type 2 Diabetic Patients." Journal of Hypertension, vol. 30, no. 5, 2012, pp. 940-7.
Cardoso CR, Marques CE, Leite NC, et al. Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients. J Hypertens. 2012;30(5):940-7.
Cardoso, C. R., Marques, C. E., Leite, N. C., & Salles, G. F. (2012). Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients. Journal of Hypertension, 30(5), 940-7. https://doi.org/10.1097/HJH.0b013e328352aba6
Cardoso CR, et al. Factors Associated With Carotid Intima-media Thickness and Carotid Plaques in Type 2 Diabetic Patients. J Hypertens. 2012;30(5):940-7. PubMed PMID: 22495135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients. AU - Cardoso,Claudia R L, AU - Marques,Carlos E C, AU - Leite,Nathalie C, AU - Salles,Gil F, PY - 2012/4/13/entrez PY - 2012/4/13/pubmed PY - 2012/8/14/medline SP - 940 EP - 7 JF - Journal of hypertension JO - J. Hypertens. VL - 30 IS - 5 N2 - OBJECTIVE: Factors associated with carotid atherosclerosis are unclear in type 2 diabetic patients. The aim was to investigate the independent correlates of carotid intima-media thickness (IMT) and plaques in these individuals. METHODS: In a cross-sectional study, we measured carotid IMT at three sites (common carotid, bifurcation and internal carotid artery) and the severity of extracranial carotid artery (ECCA) atherosclerosis by plaque score in 441 type 2 diabetic patients. Nontraditional cardiovascular risk factors [ambulatory blood pressures (BPs), aortic stiffness, C-reactive protein and ankle-brachial index) were obtained. Multivariate linear and logistic regressions assessed the independent correlates of carotid IMT and ECCA plaque score. RESULTS: Patients with greater carotid IMT or plaque scores had worse clinical and laboratory profile than those with lower IMT and plaque scores, including higher BPs, aortic stiffness and prevalences of diabetic complications. On multivariate analysis, carotid IMT and plaques were mainly associated with older age, male sex, current-past smoking and ambulatory BPs, but not with clinic BPs. Night-time pulse pressure was the most important modifiable determinant of increased carotid IMT. No microvascular complication was independently associated with carotid atherosclerosis, except retinopathy for plaque score. Additionally, internal carotid IMT and plaque score were associated with ankle-brachial index in the subgroup of patients without macrovascular diseases. CONCLUSION: In type 2 diabetic patients, older age, male sex, smoking status and ambulatory BPs, particularly night-time pulse pressure, were the main independent correlates of ultrasonographic carotid atherosclerosis. This finding reinforces the importance of ambulatory BP monitoring in type 2 diabetes management. SN - 1473-5598 UR - https://www.unboundmedicine.com/medline/citation/22495135/Factors_associated_with_carotid_intima_media_thickness_and_carotid_plaques_in_type_2_diabetic_patients_ L2 - http://dx.doi.org/10.1097/HJH.0b013e328352aba6 DB - PRIME DP - Unbound Medicine ER -