{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:29:30Z","timestamp":1791829770637,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T00:00:00Z","timestamp":1555286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To quantify the risk of different non\u2010invasive arterial stiffness measurements with macrovascular disease and all\u2010cause mortality in high\u2010risk people with Type 2 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective cohort study of 1910 people with Type 2 diabetes included in the Second Manifestations of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>erial disease (<jats:styled-content style=\"fixed-case\">SMART<\/jats:styled-content>) study. Arterial stiffness was assessed by brachial artery pulse pressure, normal range (\u22650.9) ankle\u2013brachial index and carotid artery distension. Cox regression was used to evaluate the effects of arterial stiffness on risk of cardiovascular events (composite of myocardial infarction, stroke and vascular mortality) and all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 380 new cardiovascular events and 436 deaths occurred during a median (interquartile range) follow\u2010up of 7.5 (4.1\u201311.0) years. A 10\u2010mmHg higher brachial pulse pressure was related to higher hazard of cardiovascular events (hazard ratio 1.09, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.02 to 1.16) and all\u2010cause mortality (hazard ratio 1.10, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.03 to 1.16). A 0.1\u2010point lower ankle\u2013brachial index within the normal range was related to a higher hazard of cardiovascular events (hazard ratio 1.13, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.01 to 1.27) and all\u2010cause mortality (hazard ratio 1.17, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.04 to 1.31). A one\u2010unit (10<jats:sup>\u22123<\/jats:sup>\u00d7<jats:styled-content style=\"fixed-case\">kP<\/jats:styled-content>a<jats:sup>\u22121<\/jats:sup>) lower carotid artery distensibility coefficient was related to a higher hazard of vascular mortality (hazard ratio 1.04, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.00 to 1.09) and all\u2010cause mortality (hazard ratio 1.04, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.00 to 1.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increased arterial stiffness, as measured by either increased pulse pressure, normal\u2010range ankle\u2013brachial index or carotid artery distensibility coefficient, is related to increased hazard of cardiovascular events and all\u2010cause mortality in people with Type 2 diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13954","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T14:47:18Z","timestamp":1553784438000},"page":"1125-1132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Arterial stiffness as a risk factor for cardiovascular events and all\u2010cause mortality in people with Type 2 diabetes"],"prefix":"10.1111","volume":"36","author":[{"given":"S.","family":"Sharif","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. L. J.","family":"Visseren","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Spiering","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. A.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Radiology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. L.","family":"Bots","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5021-5227","authenticated-orcid":false,"given":"J.","family":"Westerink","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the SMART study 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