Glycemic control and arterial stiffness in a Brazilian rural population: Baependi Heart Study

Abstract

Background: Increased arterial stiffness predicts morbidity and mortality, independently of other cardiovascular risk factors, and glycemic control impairments are related to higher vascular stiffness. The aim of this study was to evaluate the association between HbA1c levels and increased arterial stiffness in a Brazilian rural population. Methods: For this study were selected 1675 individuals (both genders and aged over 18 years) resident in the municipality of Baependi, a city located in the Southeast of Brazil. HbA1c levels were determined by HPLC. Pulse wave velocity (PWV) was measured with a non-invasive automatic device (Complior). Results: HbA1c levels were associated with an increased PWV. This was more relevant for the third tertile of age. In addition, logistic regression multivariate model including age, blood pressure, gender, BMI and fasting glucose showed that the elevation of a single unit percentage of HbA1c represented an increase of 54 % in the odds of increased arterial stiffness [OR 1.54 (95 % CI 1.01-2.17)]. Both, HbA1c and fasting glucose showed higher discriminatory power in the risk assessment for increased arterial stiffness in the non-diabetic when compared to the diabetic group (AUC of HbA1c = 0.71 vs 0.57, p = 0.02; AUC of fasting glucose = 0.66 vs 0.45, p = 0.0007, respectively). Conclusion: Our findings indicate that a increase in HbA1c levels is associated with increased arterial stiffness and that both, HbA1c and fasting glucose, presented higher discriminatory power in the risk assessment for increased arterial stiffness in the non-diabetic group as compared to diabetic individuals.