Abstract P399: Abnormal Ankle-Brachial Index Values are Associated With a Greater Prevalence of Left Ventricular Hypertrophy, Renal Impairment and Relevant Vascular Findings in Diabetic Hypertensive Patients

Abstract

Few studies have examined the correlation between the presence of peripheral artery disease diagnosed by ankle-brachial-index (ABI) and cumulative target organ damage (kidney, heart and vessels) in hypertensive patients with diabetes. For this purpose, we evaluated the prevalence of target organ damage as evidenced by an echocardiogram, Doppler carotid scan, retinography and glomerular filtration rate according to ABI values in 99 hypertensive diabetic patients. The patients were classified into a normal ABI group (1.4 ≥ ABI > 0.9) and abnormal ABI group (ABI ≤ 0.9 or ABI>1.4). From the data obtained, we analysed cumulative number, mean and frequency (mean) of lesions in target organs. The mean age of the patients was 65.4 ±7 years, and 61.6% were women. There were no differences concerning age, gender, race, body mass index, and metabolic profile between the normal (49 patients) and abnormal ABI group (50 patients), but higher levels of systolic blood pressure were observed in abnormal ABI group compared to normal ABI group (170.3 ± 26 vs. 153.3 ± 18; p = 0.002). In patients with abnormal ABI, it was observed a higher prevalence of left ventricular hipertrophy (56% vs. 26,5%, p = 0,003), internal carotid stenosis > 50% (13,7% vs. 3,2%, p = 0,009) and glomerular filtration rate < 60ml/1,73m 2 /min (33,3% vs. 12,8%, p = 0,018). Abnormal ABI group has a higher frequency of 2 or more lesions (54% vs. 20.4%, p < 0.001), a greater mean number of lesions (2.37 ± 1 vs. 0.71 ± 0.7, p < 0.001), as well as a higher frequency of target organs damage (0.36 ± 0.31 vs. 0.19 ± 0.19, p = 0.001). Multiple linear regression analysis revealed abnormal ABI as an independent factor related to the higher frequency of target organ damage (OR = 13.22; 95% CI = 1.81-24.63; p = 0.024). In conclusion, hypertensive diabetic patients with abnormal ABI values had a higher prevalence of single and cumulative target organ damage.