Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes
Background: In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Diabetes Epidemiology and Management |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266697062300032X |
| _version_ | 1797632673756217344 |
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| author | Charles F. Hayfron-Benjamin Theresa Ruby Quartey-Papafio Tracy Amo-Nyarko Ewuradwoa A Antwi Patience Vormatu Melody Kwatemah Agyei-Fedieley Kwaku Amponsah Obeng |
| author_facet | Charles F. Hayfron-Benjamin Theresa Ruby Quartey-Papafio Tracy Amo-Nyarko Ewuradwoa A Antwi Patience Vormatu Melody Kwatemah Agyei-Fedieley Kwaku Amponsah Obeng |
| author_sort | Charles F. Hayfron-Benjamin |
| collection | DOAJ |
| description | Background: In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP and its control with neural, renal, and retinal microvascular dysfunction. Methods: This was a cross-sectional study among 403 adults with T2D. Microvascular dysfunction was based on nephropathy (albumin-creatinine ratio ≥ 30 mg/g), neuropathy (vibration perception threshold ≥ 25 V and/or Diabetic Neuropathy Symptom score > 1), and retinopathy (based on retinal photography). Logistic regression was used to examine the associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction with adjustments for age, sex, diabetes duration, smoking pack years, HbA1c concentration, total cholesterol concentration, and BMI. Results: The mean age (± SD), proportion of females, and proportion of hypertensives were 56.35 (± 9.91) years, 75.7%, and 49.1%, respectively. In a fully adjusted model, hypertension was significantly associated with neuropathy [odds ratio 3.44, 95% confidence interval 1.96–6.04, P < 0.001] and nephropathy [2.05 (1.09–3.85), 0.026] but not for retinopathy [0.98 (0.42–2.31), 0.970]. Increasing Z-score systolic BP was significantly associated with nephropathy [1.43 (1.05–1.97), 0.025] but not for neuropathy [1.28 (0.98–1.67), 0.075] or retinopathy [1.27 (0.84–1.91), 0.261]. Increasing Z-score diastolic BP was significantly associated with nephropathy [1.81 (1.32 – 2.49), < 0.001] but not retinopathy [1.38 (0.92–2.05), 0.120] or neuropathy [0.86 (0.67–1.10), 0.230]. Conclusion: Our study shows varying strengths of associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction in different microcirculatory beds. Hypertension prevention and/or control may be valuable in the prevention/treatment of microvascular disease, especially nephropathy, and neuropathy. |
| first_indexed | 2024-03-11T11:40:10Z |
| format | Article |
| id | doaj.art-0bc4d79e243846d38fa36701bfa37eed |
| institution | Directory Open Access Journal |
| issn | 2666-9706 |
| language | English |
| last_indexed | 2024-03-11T11:40:10Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Diabetes Epidemiology and Management |
| spelling | doaj.art-0bc4d79e243846d38fa36701bfa37eed2023-11-10T04:16:29ZengElsevierDiabetes Epidemiology and Management2666-97062023-10-0112100160Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetesCharles F. Hayfron-Benjamin0Theresa Ruby Quartey-Papafio1Tracy Amo-Nyarko2Ewuradwoa A Antwi3Patience Vormatu4Melody Kwatemah Agyei-Fedieley5Kwaku Amponsah Obeng6Departments of Internal Medicine, Vascular Medicine, and Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Cardiovascular Sciences, Amsterdam, the Netherlands; Department of Physiology, University of Ghana Medical School, Ghana; Department of Anesthesia and Critical Care, Korle Bu Teaching Hospital and University of Ghana Medical School, Ghana; Corresponding author at: Departments of Internal Medicine, Vascular Medicine, and Respiratory Medicine, Amsterdam UMC, University of Amsterdam, P O Box DC 605, Dansoman, Accra, Ghana.Department of Anesthesia and Critical Care, Korle Bu Teaching Hospital and University of Ghana Medical School, GhanaDepartment of Physiology, University of Ghana Medical School, GhanaDepartment of Medicine, 37 Military Hospital, GhanaDepartment of Biomedical Sciences, University of Cape Coast, GhanaDepartment of Physiology, University of Ghana Medical School, Ghana; Department of Anaesthesia, Greater Accra Regional Hospital, Accra, GhanaDepartment of Physiology, University of Ghana Medical School, Ghana; Department of Anesthesia and Critical Care, Korle Bu Teaching Hospital and University of Ghana Medical School, GhanaBackground: In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP and its control with neural, renal, and retinal microvascular dysfunction. Methods: This was a cross-sectional study among 403 adults with T2D. Microvascular dysfunction was based on nephropathy (albumin-creatinine ratio ≥ 30 mg/g), neuropathy (vibration perception threshold ≥ 25 V and/or Diabetic Neuropathy Symptom score > 1), and retinopathy (based on retinal photography). Logistic regression was used to examine the associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction with adjustments for age, sex, diabetes duration, smoking pack years, HbA1c concentration, total cholesterol concentration, and BMI. Results: The mean age (± SD), proportion of females, and proportion of hypertensives were 56.35 (± 9.91) years, 75.7%, and 49.1%, respectively. In a fully adjusted model, hypertension was significantly associated with neuropathy [odds ratio 3.44, 95% confidence interval 1.96–6.04, P < 0.001] and nephropathy [2.05 (1.09–3.85), 0.026] but not for retinopathy [0.98 (0.42–2.31), 0.970]. Increasing Z-score systolic BP was significantly associated with nephropathy [1.43 (1.05–1.97), 0.025] but not for neuropathy [1.28 (0.98–1.67), 0.075] or retinopathy [1.27 (0.84–1.91), 0.261]. Increasing Z-score diastolic BP was significantly associated with nephropathy [1.81 (1.32 – 2.49), < 0.001] but not retinopathy [1.38 (0.92–2.05), 0.120] or neuropathy [0.86 (0.67–1.10), 0.230]. Conclusion: Our study shows varying strengths of associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction in different microcirculatory beds. Hypertension prevention and/or control may be valuable in the prevention/treatment of microvascular disease, especially nephropathy, and neuropathy.http://www.sciencedirect.com/science/article/pii/S266697062300032XBlood pressure controlHypertensionMicrovascular complicationsNephropathyNeuropathyRetinopathy |
| spellingShingle | Charles F. Hayfron-Benjamin Theresa Ruby Quartey-Papafio Tracy Amo-Nyarko Ewuradwoa A Antwi Patience Vormatu Melody Kwatemah Agyei-Fedieley Kwaku Amponsah Obeng Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes Diabetes Epidemiology and Management Blood pressure control Hypertension Microvascular complications Nephropathy Neuropathy Retinopathy |
| title | Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes |
| title_full | Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes |
| title_fullStr | Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes |
| title_full_unstemmed | Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes |
| title_short | Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes |
| title_sort | relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes |
| topic | Blood pressure control Hypertension Microvascular complications Nephropathy Neuropathy Retinopathy |
| url | http://www.sciencedirect.com/science/article/pii/S266697062300032X |
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