Background: Diabetes and hypertension increase arterial stiffness and cardiovascular events in all societies studied\nso far; sub-Saharan African studies are sparse. We investigated factors affecting arterial function in Ghanaians with\ndiabetes, hypertension, both or neither.\nMethod: Testing the hypothesis that arterial stiffness would progressively increase from controls to multiply\naffected patients, 270 participants were stratified into those with diabetes or hypertension only, with both, or\nwithout either. Cardio-ankle vascular index (CAVI), heartââ?¬â??ankle pulse wave velocity (haPWV), aortic PWV (PWVao)\nby Arteriograph, aortic and brachial blood pressures (BP), were measured.\nResults: In patients with both diabetes and hypertension compared with either alone, values were higher of\nCAVI (mean Ã?± SD, 8.3 Ã?± 1.2 vs 7.5 Ã?± 1.1 and 7.4 Ã?± 1.1 units; p < 0.05), PWVao (9.1 Ã?± 1.4 vs 8.7 Ã?± 1.9 and 8.1 Ã?± 0.\n9 m/s; p < 0.05) and haPWV (8.5 Ã?± 1 vs 7.9 Ã?± 1 and 7.2 Ã?± 0.7 m/s; p < 0.05) respectively. In multivariate analysis,\nage, having diabetes or hypertension and BMI were independently associated with CAVI in all participants (Ã?² = 0.49, 0.2,\n0.17 and -0.2 units; p < 0.01, respectively). Independent determinants of PWVao were heart rate, systolic BP and\nage (Ã?² = 0.42, 0.27 and 0.22; p < 0.01), and for haPWV were systolic BP, age, BMI, diabetes and hypertension status\n(Ã?² = 0.46, 0.32, -0.2, 0.2 and 0.11; p < 0.01).\nConclusion: In this sub-Saharan setting with lesser atherosclerosis than the western world, arterial stiffness is\nsignificantly greater in patients with coexistent diabetes and hypertension but did not differ between those with\neither diabetes or hypertension only. Simple, reproducibly measured PWV/CAVI may offer effective and efficient\ntargets for intervention
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