Arterial Stiffness May Predict Type 2 Diabetes Risk Better Than Blood Pressure, Standard Risk Factors


Individuals with elevated arterial stiffness combined with high blood pressure had the highest risk of developing type 2 diabetes.

Arterial stiffness may be a better predictor for the future risk of type 2 diabetes (T2D) than blood pressure, with stiffer arteries showing the highest risk for the development of T2D, according to a study published in Hypertension, a peer-reviewed journal of the American Heart Association (AHA).

“Identification of individuals at high risk of developing type 2 diabetes is of utmost importance since early intervention can help prevent the onset and slow the progress of the condition,” said senior study author Anxin Wang, PhD, researcher at the China National Clinical Research Center for Neurological Diseases at Beijing Tiantan Hospital in Beijing, China, in a press release.

Previous studies in this area have found that hypertension is a risk factor for T2D, in addition to arterial stiffness.

“Since people with either hypertension or arterial stiffness tend to have a higher risk of developing type 2 diabetes, we investigated which of these factors may be more effective in predicting an individual’s future risk of type 2 diabetes,” Wang said in a press release.

The research team examined health data from 11,156 participants of the Kailuan study, which is an ongoing analysis of more than 100,000 adults between 18 and 98 years of age in Tangshan, China. Resting blood pressure measurements and fasting blood samples were taken every 2 years and measurements of artery wall stiffness were added in 2010.

The investigators calculated artery wall stiffness using brachial-ankle pulse wave velocity, a standard technique that uses a blood pressure cuff placed on a participant’s arm and ankle to measure the rate at which pressure waves move down the blood vessels.

Participants were defined as having hypertension if their resting blood pressure was 140 mm Hg/90 mm Hg or greater. The AHA’s 2017 guideline considers people with blood pressure of 130 mm Hg/80 mm Hg or higher to have hypertension.

The investigators defined patients as having T2D based on either measuring a fasting blood sugar level ≥7.0 mmol/L or via a physician diagnosis.

The analysis found a few main points, including:

  • Study participants with elevated arterial stiffness combined with high blood pressure had the highest risk of developing T2D.
  • Individuals with normal blood pressure and stiffer arteries had an increased risk of T2D as compared to the group with ideal vascular function.
  • Participants with high blood pressure and normal arterial stiffness had the lowest risk of T2D.

“We were surprised to find that people with increased arterial stiffness were more likely to develop type 2 diabetes, whether they had high blood pressure or not,” Wang said in the press release. “These results provide strong evidence that measuring arterial stiffness may be a better predictor than blood pressure in determining an individual’s future risk of type 2 diabetes.”

The analysis also found that the combination of high blood pressure and stiffer arteries was more likely in men and among individuals who were older, had a higher BMI, and higher heart rate and reported smoking cigarettes and drinking alcohol. Those with increased arterial stiffness also had higher fasting blood glucose and cholesterol levels compared to participants who did not.

”These findings provide new insight into the prevention of type 2 diabetes, indicating that early detection and treatment for high blood pressure and arterial stiffness may help reduce the risk of developing type 2 diabetes,” Wang added in the press release.

Wang added that more studies are necessary to further investigate the underlying mechanisms involved in the associations for arterial stiffness, high blood pressure, and T2D risk and to determine the optimal range of arterial thickness and blood pressure for preventing T2D.

“This finding that arterial stiffness increases the risk for developing type 2 diabetes supports our existing understanding of cardiovascular disease and type 2 diabetes,” AHA chief medical officer for prevention, Eduardo Sanchez, MD, MPH, FAHA, FAAFP, who is the clinical lead for Know Diabetes by Heart, a collaborative initiative between the AHA and the American Diabetes Association, said in the press release. “We look forward to future investigations about the mechanisms between arterial stiffness and type 2 diabetes risk.”


Artery stiffness may predict Type 2 diabetes risk better than BP and standard risk factors. American Heart Association. May 16, 2022. Accessed May 17, 2022.

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