Key result
Coexisting diabetes and hypertension were associated with the highest carotid total plaque area (β exponent 1.64; 95% CI 1.20-2.26) compared to controls, while diabetes alone showed no difference.
Why the study?
Although diabetes is classically considered more atherogenic than hypertension, stroke and heart attack incidences are higher in hypertension alone, prompting a comparison of their atherosclerotic burden.
Does hypertension or diabetes have a greater association with subclinical atherosclerosis burden (total plaque area) in adults without prior cardiovascular events?
Cross-Sectional (n=606)
Does hypertension or diabetes have a greater association with subclinical atherosclerosis burden (total plaque area) in adults without prior cardiovascular events?
Hypertension, either alone or combined with diabetes, is associated with a higher burden of subclinical atherosclerosis than diabetes alone in patients without prior cardiovascular events.
Hypertension associates more strongly with subclinical atherosclerosis than diabetes alone; hypothesis-generating for risk stratification, needs prospective confirmation.
BACKGROUND/OBJECTIVE: the determination of the carotid total plaque area (TPA) is an indicator of subclinical atherosclerosis and a useful tool in early cardiovascular prevention. Classically, diabetes has been considered the most atherogenic disease, even more so than hypertension, but the incidence of stroke and heart attack is higher in patients with hypertension than in patients with diabetes alone. Therefore, in this study, we compared hypertension and diabetes with regard to the burden of atherosclerosis. METHODS: a cross-sectional observational study was carried out on adults (n = 606). Those with a history of a cardiovascular event were excluded. RESULTS: median age was 65 years (IQR 17), 58.6% women. People with diabetes and hypertension had the highest TPA (β exponent: 1.64; 95% CI 1.20-2.26), followed by people with hypertension alone (β exponent: 1.39; 95% CI 1.05-1.86), while people with diabetes alone had no differences (P = .379) with respect to the control group. CONCLUSION: This cross-sectional study, though limited, emphasizes the need for larger prospective studies to validate the clinical significance of these findings and highlights the importance of routine monitoring of subclinical atherosclerosis in hypertensive patients to assess the effectiveness of preventive therapy.
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Carrillo et al. (2025) conducted a cross-sectional in Subclinical atherosclerosis (n=606). Diabetes and hypertension vs. Control group was evaluated on carotid total plaque area (TPA) (β exponent 1.64, 95% CI 1.20-2.26). Coexisting diabetes and hypertension were associated with the highest carotid total plaque area (β exponent 1.64; 95% CI 1.20-2.26) compared to controls, while diabetes alone showed no difference.
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