Longer diabetes duration is the primary driver of endothelial dysfunction in T2DM, while age, hypertension, and poor glycemic control are associated with smooth muscle dysfunction and arterial stiffness.
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Distinguishes diabetes duration-driven endothelial from age/hypertension-driven smooth muscle dysfunction in T2DM; hypothesis-generating for differential therapies.
In T2DM patients, impairment of endothelium-dependent vasodilation was independently associated only with longer diabetes duration while no association with other established risk factors was found. Vascular smooth muscle dysfunction and increased arterial stiffness were more prominent in older T2DM patients with hypertension. Worse glycemic control was associated with impaired vascular smooth muscle function.
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Naka et al. (2012) studied this question.
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