Does concomittant hypertension increase the risk of peripheral arterial disease in Nigerians with type 2 diabetes mellitus?

Citation:
Adebayo, O, Soyoye D, Enikuomehin C, Ayoola O, Kolawole B, Ikem R.  2016.  Does concomittant hypertension increase the risk of peripheral arterial disease in Nigerians with type 2 diabetes mellitus?, 2016/10/14

Abstract:

Background: Peripheral arterial disease is a disorder due to obstruction of blood supply to extremities. Diabetes mellitus and hypertension are predisposing factors.Objective: To determine if the presence of concurrent hypertension increases the risk of peripheral arterial disease (PAD) in Nigerians with type 2 diabetes.
Methods: This was a cross-sectional study that included 160 persons living with diabetes mellitus (60 subjects had type 2 diabetes (T2DM) while 100 subjects had concurrent diabetes and hypertension (DM-HTN)). The presence of PAD was determined by history of intermittent claudication, palpation of dorsalis pedis and posterior tibial arteries, ankle-brachial pressure indexes (ABPI), and measurement of intimal medial thickness [IMT] and spectral pattern on duplex ultrasound imaging of the femoropopliteal arteries. Fasting blood glucose (FBG), glycosylated haemoglobin (HbA1C) and some other parameters were obtained from subjects in both groups. Comparisons were drawn between patients with diabetes alone and diabetic-hypertensives.
Results: Mean age of T2DM only was 56.4±10.4 years and 59.4±8.5 years in DM-HTN. FBG (mmol/l) in T2DM only was 7.9±3.6 and 8.0±3.4 in DM-HTN; HbA1C (%) in T2DM group was 7.4±2.2 and 7.3±1.7 in DM-HTN. Prevalence of PAD was 74.9% in people with T2DM only and 70% among DM-HTN group using IMT as reference method. The prevalence of PAD in T2DM based on history of intermittent claudication, clinical palpation, ABPI and spectral pattern was 20.0, 26.7, 20.3, and 40.7% respectively while the prevalence of PAD in DM-HTN using history of intermittent claudication, clinical palpation, ABPI and spectral pattern was 26.0, 35.8, 22.0 and 50.0% respectively.
Conclusion: Prevalence of PAD is high among persons with diabetes mellitus. The presence of hypertension does not seem to confer any risk of PAD in people with T2DM only. In addition, traditional bedside methods of clinical pulse palpation and ankle-brachial pressure index of assessing PAD are still useful.

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