Association of pulse pressure with carotid atherosclerosis in patients with type 2 diabetes mellitus

Pulse pressure is known to be a potent risk factor for cardiovascular disease. However, it has not been determined whether pulse pressure is associated with cerebrovascular disease in patients with diabetes mellitus. The purpose of the present study was to investigate association of pulse pressure with carotid atherosclerosis in patients with diabetes and to determine whether age and gender affect the association. A cross-sectional study was performed using outpatients with type 2 diabetes. Carotid atherosclerosis and arterial stiffness were evaluated by intima-media thickness of common carotid arteries (IMT) and aortic pulse wave velocity (a-PWV), respectively. The relationship of brachial pulse pressure with IMT was analyzed. Pulse pressure was significantly correlated with age, duration of diabetes, systolic blood pressure, serum sialic acid, a-PWV and IMT. The mean IMT in the highest tertile group of pulse pressure after adjustment for gender was significantly higher than the mean IMT in the lowest tertile group. In analysis using subgroups of gender, a significant correlation between pulse pressure and IMT was shown in women but not in men. In multiple regression analysis, there was a significant correlation between pulse pressure and IMT in women independently of age, body mass index, systolic blood pressure, hemoglobin A1c, atherogenic index, a-PWV, history of therapy for hypertension and history of nephropathy. The results of this study suggest that pulse pressure is a major age-independent predictor of carotid atherosclerosis in female patients with diabetes.