Asymptomatic Cardiovascular Disorders in a Cohort of Clinically Stable Type 2 Diabetes Mellitus Patients in South Eastern Nigeria: A Cross Sectional Study

Abstract

Introduction: Coronary artery disease (CAD), stroke and peripheral artery disease (PAD) are commonly referred to as cardiovascular disorders (CVD) due to a common underlying pathophysiology of atherosclerosis and are more common in diabetic patients. This study was carried out to determine the pattern and associated factors of CAD and PAD in asymptomatic patients with  type 2 diabetes mellitus in South east Nigeria. Materials and Methods: One hundred and twenty stable adults with type 2 diabetes mellitus  were recruited consecutively from two out-patient clinics in two tertiary hospitals in South east Nigeria at Nnewi and Enugu. They were assessed for risk factors for CVD including hypertension, obesity and dyslipidaemia. Their ankle-brachial index (ABI) was measured using a hand-held doppler and they also had a 12 lead ECG. Results were analyzed using SPSS V23; p value of < 0.05 considered significant. Results: There were 60 males and 60 females, with a mean age of 61.7(11.2) years and mean diabetes duration of 127.7(99.9) months. Dyslipidaemia was present in 73.3%, 70% had hypertension, PAD was present in 55.8%, while 16.5% had CAD. PAD was more common in those with higher BMI (p = 0.04), higher diastolic BP (p = 0.03) and higher mean arterial pressure (p = 0.03). On further multivariate stepwise regression analysis, there was no significant predictor of PAD. None of the clinical factors were associated with CAD. Conclusion: PAD and CAD are common in patients with type2 DM even in the absence of symptoms. Obesity, high diastolic and high mean arterial pressure are more common in patients with PAD.