Artery Stiffness a Better Predictor of T2D Than Blood Pressure


Identifying these risk factors can help with early detection of T2D.

Arterial stiffness has been identified as a better predictor of future risk of Type 2 diabetes (T2D) than blood pressure, according to a major new study.

Individuals with a combination of high blood pressure and stiffer arteries had the highest risk of developing diabetes, according to the study, published in Hypertension.1

Anxin Wang, PhD, senior study author and a researcher at the China National Clinical Research Center for Neurological Diseases at Beijing Tiantan Hospital in Beijing, China, and colleagues examined health data from 11,156 participants of the Kailuan Study,2 an ongoing, prospective study of more than 100,000 adults aged 18 to 98 years in Tangshan, China.

In 2017, 6 years after the cohort began being tracked, approximately 7% of the study participants had developed T2D.

Researchers found that 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 also had an increased risk of T2D, vs the group with ideal vascular function. Conversely, participants with high blood pressure and normal arterial stiffness had the lowest risk of T2D.

“Identification of individuals at high risk of developing [T2D] is of utmost importance since early intervention can help prevent the onset and slow the progress of the condition,” Wang said in a news release3 from the American Heart Association, which publishes Hypertension.

According to Wang, the research team was surprised to find that people with increased arterial stiffness were more likely to develop T2D, whether they had high blood pressure or not. “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 [T2D].”

The analysis also found that the combination of high blood pressure and stiffer arteries was more likely in men, people who were older, had a higher body mass index (BMI) and higher heart rate, and reported smoking cigarettes and drinking alcohol.

People with increased arterial stiffness also had higher fasting blood glucose and cholesterol levels compared to participants who did not. Adjusting the analysis to consider BMI did not change the association between arterial stiffness and T2D, however.

“This finding that arterial stiffness increases the risk for developing Type 2 diabetes supports our existing understanding of cardiovascular disease and Type 2 diabetes,” said Eduardo Sanchez, MD, MPH, chief medical officer for prevention at the American Heart Association and clinical lead for Know Diabetes by Heart, a collaborative initiative between the American Heart Association and the American Diabetes Association.

“We look forward to future investigations about the mechanisms between arterial stiffness and [T2D] risk,” Sanchez said.

More studies are needed 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, Wang noted.


1. Tian X, Zuo Y, Chen S, et al. Hypertension, arterial stiffness, and diabetes: A prospective cohort study. Hypertension. Published online May 16, 2022. Doi:10.1161/HYPERTENSIONAHA.122.19256

2. Liu X, Cui L, Wang A, et al. Cumulative exposure to ideal cardiovascular health and incident diabetes in a Chinese population: The Kailuan Study. J Am Heart Assoc. 2016;5(9):e004132. Doi:10.1161/JAHA.116.004132

3. Artery stiffness may predict type 2 diabetes risk better than BP and standard risk factors. News release. American Heart Association. May 16, 2022. Accessed May 24, 2022. 

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