Prevalence of lower extremity Peripheral artery disease among adult diabetes patients in Southwestern Uganda

Samson Okello, Alexander Millard, Rogers Owori, Stephen B. Asiimwe, Mark J. Siedner, Joselyn Rwebembera, Laurence A. Wilson, Christopher C. Moore, Brian H. Annex

Research output: Contribution to journalArticle

Abstract

Background: Peripheral artery disease (PAD) is a major complication of atherosclerosis. PAD can be diagnosed with low-cost diagnostic techniques and is associated with significant morbidity and mortality. While the major epidemiologic risk factors for PAD have been established in the western world, data from resource-poor countries are limited. We performed a cross-sectional study to determine the prevalence and correlates of PAD among patients with diabetes at Mbarara Referral Hospital in southwestern Uganda.Methods: We consecutively enrolled diabetes patients aged 50 years or greater presenting to the outpatient clinic. We collected blood for fasting lipid profile, HIV serology, and glycosylated hemoglobin, measured blood pressure and ankle brachial index, and administered the Edinburgh Claudication Questionnaire (ECQ). We also surveyed patients for other PAD risk factors. We used logistic regression to determine correlates of PAD.Results: We enrolled 229 diabetes patients. The median age of 60 years (IQR 55-66), and 146 (63.7%) were female. Fifty five patients (24%) had PAD (ABI of ≤ 0.9). Of these, 48 /55 (87.27%) had mild PAD (ABI 0.71-0.9) while 7/55 (12.73%) had moderate to severe PAD (ABI < 0.7). Amongst those with PAD, 24/55 (43.64%) reported claudication by the ECQ. Correlates of PAD included female sex (AOR 2.25, 95% CI 1.06 - 4.77, p = 0.034), current high blood pressure (AOR 2.59, 95% CI 1.25-5.33, p = 0.01), and being on a sulfonylurea-glibenclamide (AOR 3.47, 95% CI 1.55 - 7.76, p = 0.002).Conclusion: PAD was common in diabetic patients in southwestern Uganda. Given its low cost and ease of measurement, ABI deserves further assessment as a screening tool for both PAD and long term cardiovascular risk amongst diabetics in this region.

Original languageEnglish (US)
Article number75
JournalBMC Cardiovascular Disorders
Volume14
DOIs
StatePublished - Jun 10 2014
Externally publishedYes

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Uganda
Peripheral Arterial Disease
Lower Extremity
Epidemiologic Factors
Costs and Cost Analysis
Ankle Brachial Index
Western World
Glyburide
Glycosylated Hemoglobin A
Serology
Ambulatory Care Facilities
Fasting
Atherosclerosis
Referral and Consultation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Okello, S., Millard, A., Owori, R., Asiimwe, S. B., Siedner, M. J., Rwebembera, J., ... Annex, B. H. (2014). Prevalence of lower extremity Peripheral artery disease among adult diabetes patients in Southwestern Uganda. BMC Cardiovascular Disorders, 14, [75]. https://doi.org/10.1186/1471-2261-14-75

Prevalence of lower extremity Peripheral artery disease among adult diabetes patients in Southwestern Uganda. / Okello, Samson; Millard, Alexander; Owori, Rogers; Asiimwe, Stephen B.; Siedner, Mark J.; Rwebembera, Joselyn; Wilson, Laurence A.; Moore, Christopher C.; Annex, Brian H.

In: BMC Cardiovascular Disorders, Vol. 14, 75, 10.06.2014.

Research output: Contribution to journalArticle

Okello, S, Millard, A, Owori, R, Asiimwe, SB, Siedner, MJ, Rwebembera, J, Wilson, LA, Moore, CC & Annex, BH 2014, 'Prevalence of lower extremity Peripheral artery disease among adult diabetes patients in Southwestern Uganda', BMC Cardiovascular Disorders, vol. 14, 75. https://doi.org/10.1186/1471-2261-14-75
Okello, Samson ; Millard, Alexander ; Owori, Rogers ; Asiimwe, Stephen B. ; Siedner, Mark J. ; Rwebembera, Joselyn ; Wilson, Laurence A. ; Moore, Christopher C. ; Annex, Brian H. / Prevalence of lower extremity Peripheral artery disease among adult diabetes patients in Southwestern Uganda. In: BMC Cardiovascular Disorders. 2014 ; Vol. 14.
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abstract = "Background: Peripheral artery disease (PAD) is a major complication of atherosclerosis. PAD can be diagnosed with low-cost diagnostic techniques and is associated with significant morbidity and mortality. While the major epidemiologic risk factors for PAD have been established in the western world, data from resource-poor countries are limited. We performed a cross-sectional study to determine the prevalence and correlates of PAD among patients with diabetes at Mbarara Referral Hospital in southwestern Uganda.Methods: We consecutively enrolled diabetes patients aged 50 years or greater presenting to the outpatient clinic. We collected blood for fasting lipid profile, HIV serology, and glycosylated hemoglobin, measured blood pressure and ankle brachial index, and administered the Edinburgh Claudication Questionnaire (ECQ). We also surveyed patients for other PAD risk factors. We used logistic regression to determine correlates of PAD.Results: We enrolled 229 diabetes patients. The median age of 60 years (IQR 55-66), and 146 (63.7{\%}) were female. Fifty five patients (24{\%}) had PAD (ABI of ≤ 0.9). Of these, 48 /55 (87.27{\%}) had mild PAD (ABI 0.71-0.9) while 7/55 (12.73{\%}) had moderate to severe PAD (ABI < 0.7). Amongst those with PAD, 24/55 (43.64{\%}) reported claudication by the ECQ. Correlates of PAD included female sex (AOR 2.25, 95{\%} CI 1.06 - 4.77, p = 0.034), current high blood pressure (AOR 2.59, 95{\%} CI 1.25-5.33, p = 0.01), and being on a sulfonylurea-glibenclamide (AOR 3.47, 95{\%} CI 1.55 - 7.76, p = 0.002).Conclusion: PAD was common in diabetic patients in southwestern Uganda. Given its low cost and ease of measurement, ABI deserves further assessment as a screening tool for both PAD and long term cardiovascular risk amongst diabetics in this region.",
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AU - Okello, Samson

AU - Millard, Alexander

AU - Owori, Rogers

AU - Asiimwe, Stephen B.

AU - Siedner, Mark J.

AU - Rwebembera, Joselyn

AU - Wilson, Laurence A.

AU - Moore, Christopher C.

AU - Annex, Brian H.

PY - 2014/6/10

Y1 - 2014/6/10

N2 - Background: Peripheral artery disease (PAD) is a major complication of atherosclerosis. PAD can be diagnosed with low-cost diagnostic techniques and is associated with significant morbidity and mortality. While the major epidemiologic risk factors for PAD have been established in the western world, data from resource-poor countries are limited. We performed a cross-sectional study to determine the prevalence and correlates of PAD among patients with diabetes at Mbarara Referral Hospital in southwestern Uganda.Methods: We consecutively enrolled diabetes patients aged 50 years or greater presenting to the outpatient clinic. We collected blood for fasting lipid profile, HIV serology, and glycosylated hemoglobin, measured blood pressure and ankle brachial index, and administered the Edinburgh Claudication Questionnaire (ECQ). We also surveyed patients for other PAD risk factors. We used logistic regression to determine correlates of PAD.Results: We enrolled 229 diabetes patients. The median age of 60 years (IQR 55-66), and 146 (63.7%) were female. Fifty five patients (24%) had PAD (ABI of ≤ 0.9). Of these, 48 /55 (87.27%) had mild PAD (ABI 0.71-0.9) while 7/55 (12.73%) had moderate to severe PAD (ABI < 0.7). Amongst those with PAD, 24/55 (43.64%) reported claudication by the ECQ. Correlates of PAD included female sex (AOR 2.25, 95% CI 1.06 - 4.77, p = 0.034), current high blood pressure (AOR 2.59, 95% CI 1.25-5.33, p = 0.01), and being on a sulfonylurea-glibenclamide (AOR 3.47, 95% CI 1.55 - 7.76, p = 0.002).Conclusion: PAD was common in diabetic patients in southwestern Uganda. Given its low cost and ease of measurement, ABI deserves further assessment as a screening tool for both PAD and long term cardiovascular risk amongst diabetics in this region.

AB - Background: Peripheral artery disease (PAD) is a major complication of atherosclerosis. PAD can be diagnosed with low-cost diagnostic techniques and is associated with significant morbidity and mortality. While the major epidemiologic risk factors for PAD have been established in the western world, data from resource-poor countries are limited. We performed a cross-sectional study to determine the prevalence and correlates of PAD among patients with diabetes at Mbarara Referral Hospital in southwestern Uganda.Methods: We consecutively enrolled diabetes patients aged 50 years or greater presenting to the outpatient clinic. We collected blood for fasting lipid profile, HIV serology, and glycosylated hemoglobin, measured blood pressure and ankle brachial index, and administered the Edinburgh Claudication Questionnaire (ECQ). We also surveyed patients for other PAD risk factors. We used logistic regression to determine correlates of PAD.Results: We enrolled 229 diabetes patients. The median age of 60 years (IQR 55-66), and 146 (63.7%) were female. Fifty five patients (24%) had PAD (ABI of ≤ 0.9). Of these, 48 /55 (87.27%) had mild PAD (ABI 0.71-0.9) while 7/55 (12.73%) had moderate to severe PAD (ABI < 0.7). Amongst those with PAD, 24/55 (43.64%) reported claudication by the ECQ. Correlates of PAD included female sex (AOR 2.25, 95% CI 1.06 - 4.77, p = 0.034), current high blood pressure (AOR 2.59, 95% CI 1.25-5.33, p = 0.01), and being on a sulfonylurea-glibenclamide (AOR 3.47, 95% CI 1.55 - 7.76, p = 0.002).Conclusion: PAD was common in diabetic patients in southwestern Uganda. Given its low cost and ease of measurement, ABI deserves further assessment as a screening tool for both PAD and long term cardiovascular risk amongst diabetics in this region.

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