Arterial Stiffness: A Review in Type 2 Diabetes

Diabetes is a growing health problem worldwide in [1]. In a prospective study the risk of cardiovascular death in patients with diabetes, without previous coronary heart disease (CHD) is equal to that of patients with CHD without diabetes, with a higher risk factor in women in [2]. This excessive risk is not explained by classic risk factors for cardiovascular disease such as smoking, LDL-cholesterol, hypertension in [3]. This has led to a search for early markers of vascular dysfunction (arterial stiffness) in diabetic patients that may pre-date the development of overt clinical disease, offer a target for early intervention and delay the progress of cardio‐ vascular disease complications. Arterial walls stiffen with age. Once, the aging-associated changes in arterial structural and functional changes were thought to be part of natural aging, but this concept changed when data emerged showing that these changes are accelerated with coexistent cardiovascular disease. For example, patients with diabetes exhibit increased stiffness even after adjusting for age in [4] and this ‘accelerated’ arterial aging is well confirmed to be a risk. Several non-invasive methods are currently used to assess vascular stiffness. An extensive theoretical review of models underlying the definitions and assessment methods of arterial stiffness estimates have been recently published in [5].