A LONGITUDINAL cohort study has identified mean arterial pressure (MAP) as a key predictor of arterial stiffness progression in adults with prediabetes, highlighting the potential importance of early blood pressure management for cardiovascular protection before the onset of diabetes.
Prediabetes and Cardiovascular Risk
The study analysed data from 5,771 adults with prediabetes enrolled in the Shougang cohort study. Researchers investigated whether several cardiometabolic risk markers were associated with arterial stiffness at baseline and over time. The markers assessed included the triglyceride glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, mean arterial pressure, BMI, and dyslipidaemia.
Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV), a recognised indicator of vascular ageing and cardiovascular risk. Progression of arterial stiffness was defined as the annual change in baPWV between baseline and the final follow-up visit.
At baseline, multivariate linear regression analyses showed significant associations between higher baPWV and several cardiometabolic markers, including the TyG index, TG/HDL-C ratio, MAP, and dyslipidaemia. However, during a mean follow-up period of 3.24 years, MAP emerged as the only marker demonstrating a consistent longitudinal association with worsening arterial stiffness.
Specifically, each one-unit increase in MAP was associated with a 0.72 cm/s per year faster progression in baPWV (95% CI, 0.40–1.04 cm/s per year). In addition, after adjustment for all covariates, the risk of arterial stiffness increased by 3% for every one-unit increase in MAP.
Blood Pressure Drives Arterial Stiffness
The authors noted that while insulin resistance-related markers and lipid abnormalities were associated with baseline vascular stiffness, elevated blood pressure appeared to play the most important role in ongoing vascular deterioration among people with prediabetes.
The findings underscore the importance of early cardiovascular risk assessment and suggest that proactive blood pressure management may help reduce vascular damage and future cardiovascular complications in individuals at high risk of developing diabetes.
Reference
Sun Q et al. Impact of cardiometabolic risk markers on the incidence and progression arterial stiffness in patients with prediabetes. J Diabetes. 2026;18(5):e70231.
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