Open Access Highly Accessed Research article

Worsened arterial stiffness in high-risk cardiovascular patients with high habitual carbohydrate intake: a cross-sectional vascular function study

Hiu-Ting Chan1, Yap-Hang Chan1, Kai Hang Yiu1, Sheung-Wai Li2, Sidney Tam3, Chu-Pak Lau1 and Hung-Fat Tse1*

Author Affiliations

1 Division of Cardiology, Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China

2 Department of Medicine, Tung Wah Hospital, Hong Kong, China

3 Department of Clinical Biochemistry Unit, Queen Mary Hospital, Hong Kong, China

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BMC Cardiovascular Disorders 2014, 14:24  doi:10.1186/1471-2261-14-24

Published: 21 February 2014



Previous studies suggested that high dietary carbohydrate intake is associated with increased cardiovascular risk through raised triglyceride and decreased high-density lipoprotein-cholesterol levels. However, the relation between carbohydrate intake and arterial stiffness has not been established. The purpose of this study was to examine this relation among high-risk cardiovascular patients.


We studied the relation between dietary macronutrient intake and arterial stiffness in 364 patients with documented cardiovascular diseases or risk equivalent (coronary artery diseases 62%, ischemic stroke 13%, diabetes mellitus 55%) and in 93 age-and-sex matched control subjects. Dietary macronutrient intake was assessed using a validated food-frequency questionnaire (FFQ) for Chinese. Heart-ankle pulse wave velocity (PWV) was measured non-invasively with a Vascular Profiling System (VP2000, Colin Corp. USA). A dietary pattern with ≥60% total energy intake derived from carbohydrates was defined as a high-carbohydrate diet according to the Dietary Reference Intakes (DRI) for Chinese.


Subjects who consumed a high-carbohydrate diet had significantly higher mean PWV than those who did not consume a high-carbohydrate diet (P = 0.039). After adjustment for potential confounders, high-carbohydrate diet was associated with significantly increased PWV [B = 73.50 (10.81 to 136.19), P = 0.022]. However, there was no significant association between high-carbohydrate diet and PWV in controls (P = 0.634).


High-carbohydrate diet is associated with increased arterial stiffness in patients with established cardiovascular disease or risk equivalent.

Macronutrient; Carbohydrate intake; Arterial stiffness; Pulse wave velocity; Secondary prevention