Endothelial Dysfunction and Large Artery Stiffness

Hypertension and type 2 diabetes (T2D) are both common chronic conditions that affect a large proportion of the world’s population. Both conditions tend to occur in the same individual, suggesting overlapping, predisposing factors. Indeed, common to both diabetes and hypertension are abnormalities in blood vessel structure and function. A number of studies have shown that compared to their nondiabetic counterparts, patients with T2D display endothelial dysfunction and accelerated arterial stiffness. Thus, a bidirectional relationship between T2D and hypertension exists and is likely exacerbated by endothelial dysfunction and large artery stiffness. In this chapter, literature on the association between T2D and hypertension are summarised with a particular focus on the changes that occur in relation to the endothelium and large arteries. The haemodynamic and biomechanical pathways involved in the bidirectional relationship between hypertension and T2D will be discussed.