Possible beneficial effect of telmisartan on glycemic control in diabetic subjects.

Comparison among Asian, Afro-Caribbeans, and white Caucasians with type 2 diabetes P atients with type 2 diabetes have two to three times the risk of dying prematurely from cardiovascular disease than their nondiabetic counterparts (1). Many studies have shown that arterial compliance is reduced in type 2 diabetes and that arterial stiffness increases with deteriorating glucose tolerance status, even before the onset of type 2 diabetes (2– 4). In a previous brief report , we studied Afro-Caribbean and white Caucasian subjects with diabetes and found a decrease in peripheral arterial compliance in the Afro-Caribbean subjects (5). We also reported an accelerated rate of aging in the elastic arteries of diabetic patients reaching a plateau by the age of 50 – 60 years (6). The present article examines the control versus diabetic differences in two races, white Caucasians and Afro-Caribbeans, and includes data on Asians from the Indian subcontinent with diabetes. Fifty-seven patients with a diagnosis of type 2 diabetes for at least 1 year (21 white Caucasian, 20 Afro-Caribbean, and 16 Asian) aged 44 – 80 years (mean Ϯ SD 61 Ϯ 7.4) and 48 healthy control subjects (30 white Caucasian and 18 Afro-Caribbean) aged 34 – 86 years (65.5 Ϯ 11.6) took part in this cross-sectional study. Pulse wave velocity of the carotid-femoral (PWV cf) was measured noninva-sively in a thoraco-abdominal segment and in an upper-limb muscular artery (PWV of the carotid-radial [PWV cr ]) using the Complior (Colson, Pantin, France) system. PWV from the aorta to the finger (PWV fin) was measured using the Finapress (Ohmeda, Madison, WI) and custom-written software (J.D.C.). Central aortic compliance (CAC) was also assessed from simultaneous measurements of ascending aortic blood flow and surrogate estimates of aortic root pressure using a method described by Liu et al. (7) and previously reported by Cameron et al. (8). Analysis of the clinical characteristics of the participants for the diabetic and control groups and by ethnicity showed that for the diabetic group, only BMI was significantly different between the races (P Ͻ 0.05), with the white patient group having the highest mean value (29.9 kg/ m 2). For the control population, only age was significantly different (P ϭ 0.01), with Caucasians being on average 8 years older than Afro-Caribbeans. Race was found to be a major determinant of PWV cr in type 2 diabetic subjects , with Afro-Caribbeans having the highest mean value (12.10 Ϯ 1.4 …