Measuring arterial stiffness in diabetic patients

The excess risk of cardiovascular disease in patients with type 2 diabetes mellitus remains largely unexplained. Arterial stiffness, an early feature of diabetic vasculopathy involving several mechanisms, results in impaired arterial compliance, which has recently been proposed as a powerful independent predictor of cardiovascular disease. Decreased arterial compliance can contribute to the development and progression of hypertension, left ventricular hypertrophy and dysfunction, and decreased myocardial perfusion, all of which are highly prevalent in type 2 diabetes mellitus. Arterial compliance has been demonstrated to be impaired in type 2 diabetes using several different technically demanding methods. An increase in the demand by clinical researchers for measurement of arterial compliance has led to the development and commercial availability of highly practicable techniques. These each utilise different aspects of the pulse pressure waveform, are simple and reliable and reflect both large and small vessel compliance, both of which are impaired in type 2 diabetes. They offer new tools for identifying patients at increased risk of developing cardiovascular complications, including those with established diabetes. In this article we introduce the reader to the concept of arterial stiffness, the significance of arterial stiffness for diabetes and the new techniques that may potentially be useful in a research or clinical setting. Copyright © 2003 John Wiley & Sons, Ltd.