Arterial stiffness is increased in type 1 diabetes (T1D), before any clinical complications of the disease are evident. The aim of the
present paper was to investigate the association between cardiac autonomic function and arterial stiffness in a cohort of young
T1D patients, without history of hypertension and any evidence of macrovascular and/or renal disease. Large artery stiffness
was assessed by measurement of carotid-femoral pulse wave velocity (PWV). Cardiac autonomic function was assessed by the
cardiovascular tests proposed by Ewing and Clarke. Patients with a high cardiac autonomic neuropathy score (≥4) had significantly
higher PWV than those with a low score (0-1). A negative, heart rate-independent, correlation between PWV and heart rate
variation during respiration was observed (r = −0.533, P < 0.001). In multivariable analysis, E/I index was the strongest correlate
of PWV (β-coefficient = −0.326, P = 0.002). Cardiac parasympathetic function is a strong predictor of large arterial stiffness, in
young T1D patients free of macrovascular and renal complications.