Abstract
Increased brachial systolic blood-pressure (BP) predicts diabetes (T2DM) but is not fully effective. Value of absolute ankle systolic BP for T2DM compared to brachial systolic BP is not known. Our objectives were to assess independent relationships of ankle-systolic BP with T2DM and cardiovascular disease in Europeans and south Asians. Cross-sectional studies of anonymised data from registered adults (n = 1087) at inner city deprived primary care practices. Study includes 63.85% ethnic minority. Systolic BP of the left and right-brachial, posterior-tibial and dorsalis-pedis-arteries measured using a Doppler probe. Regression models’ factors were age, sex, ethnicity, body mass index (BMI) and waist height ratio (WHtR). Both brachial and ankle systolic-BP increase with diabetes in Europeans and south Asians. We demonstrated that there was a significant positive independent association of ankle BP with diabetes, regardless of age and sex compared to Brachial. There was stronger negative association of ankle blood pressure with cardiovascular disease, after adjustment for BMI, WHtR and ethnicity. Additionally, we found that ankle BP were significantly associated with cardiovascular disease in south Asians more than the Europeans; right posterior tibial. Ankle systolic BPs are superior to brachial BPs to identify risks of Type 2DM and cardiovascular diseases for enhanced patient care.
Highlights
Increased brachial systolic blood-pressure (BP) predicts diabetes (T2DM) but is not fully effective
The diabetes screening tools for T2DM are based on age, gender, familyhistory of T2DM (FHoD), high brachial blood-pressure (BP), ethnicity, physical activity and body-mass-index (BMI)
Ankle systolic BP are associated with cardiovascular disease more than the brachial. This is a first study of comparison of associations of brachial and ankle BP with diabetes and cardiovascular disease
Summary
Increased brachial systolic blood-pressure (BP) predicts diabetes (T2DM) but is not fully effective. Regression models’ factors were age, sex, ethnicity, body mass index (BMI) and waist height ratio (WHtR). Both brachial and ankle systolic-BP increase with diabetes in Europeans and south Asians. The diabetes screening tools for T2DM are based on age, gender (gestational diabetes), familyhistory of T2DM (FHoD), high brachial blood-pressure (BP), ethnicity, physical activity and body-mass-index (BMI). These do not perform well and miss 50% of patients with T2DM2,3. Greater increases in ankle systolic BP and cardiovascular disease have been reported in south Asians compared to Europeans with a history of T 2DM6,7. We hypothesized that ankle systolic BP will be a more significant discriminator for T2DM and cardiovascular disease than brachial systolic BP, especially in south Asians
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