Bromocriptine Improves Central Aortic Stiffness in Adolescents With Type 1 Diabetes: Arterial Health Results From the BCQR-T1D Study. Issue 2 (6th December 2022)

• Record Type: Journal Article
• Authors: Schäfer, Michal; Browne, Lorna P.; Truong, Uyen; Bjornstad, Petter; Tell, Shoshana; Snell-Bergeon, Janet; Baumgartner, Amy; Hunter, Kendall S.; Reusch, Jane E.B.; Barker, Alex J.; Nadeau, Kristen J.; Schauer, Irene E.
• Is Part Of: Hypertension. Volume 80:Issue 2(2022)
• Page Start: 482
• Page End: 491
• Publication Date: 2022-12-06
• Subjects: bromocriptine -- hemodynamics -- hypertension -- pediatrics -- stiffness; Hypertension -- Periodicals; Hypertension -- Treatment -- Periodicals; 616.132005
• DOI: 10.1161/HYPERTENSIONAHA.122.19547
• Languages: English
• ISSNs: 0194-911X

Abstract

Abstract : Background: The presence of vascular dysfunction is a well-recognized feature in youth with type 1 diabetes (T1D), accentuating their lifetime risk of cardiovascular events. Therapeutic strategies to mitigate vascular dysfunction are a high clinical priority. In the bromocriptine quick release T1D study (BCQR-T1D), we tested the hypothesis that BCQR would improve vascular health in youth with T1D. Methods: BCQR-T1D was a placebo-controlled, random-order, double-blinded, cross-over study investigating the cardiovascular and metabolic impact of BCQR in T1D. Adolescents in the BCQR-T1D study were randomized 1:1 to phase-1: 4 weeks of BCQR or placebo after which blood pressure and central aortic stiffness measurements by pulse wave velocity, relative area change, and distensibility from phase-contrast magnetic resonance imaging were performed. Following a 4-week washout period, phase 2 was performed in identical fashion with the alternate treatment. Results: Thirty-four adolescents (mean age 15.9±2.6 years, hemoglobin A1c 8.6±1.1%, body mass index percentile 71.4±26.1, median T1D duration 5.8 years) with T1D were enrolled and had magnetic resonance imaging data available. Compared with placebo, BCQR therapy decreased systolic (∆=−5 mmHg [95% CI, −3 to −7]; P <0.001) and diastolic blood pressure (∆=−2 mmHg [95% CI, −4 to 0]; P =0.039). BCQR reduced ascending aortic pulse wave velocity (∆=−0.4 m/s; P =0.018) and increased relative area change (∆=−2.6%, P =0.083) and distensibility (∆=0.08%/mmHg; P =0.017). In the thoraco-abdominal aorta, BCQR decreased pulse wave velocity (∆=−0.2 m/s; P =0.007) and increased distensibility (∆=0.05 %/mmHg; P =0.013). Conclusions: BCQR improved blood pressure and central and peripheral aortic stiffness and pressure hemodynamics in adolescents with T1D over 4 weeks versus placebo. BCQR may improve aortic stiffness in youth with T1D, supporting future longer-term studies.