Absent Pulses Up Risk of Vascular Events, ESRD in Type 2 Diabetes

Every additional absent dorsalis pedis or posterior tibial pulse linked to increased risk of all outcomes.
Every additional absent dorsalis pedis or posterior tibial pulse linked to increased risk of all outcomes.

(HealthDay News) -- For patients with type 2 diabetes, absent dorsalis pedis and/or posterior tibial pulses are associated with increased risk of major vascular outcomes, according to a study published online in Diabetes Care.

Kamel Mohammedi, MD, PhD, from the University of Sydney, and colleagues used data from 11,120 patients with type 2 diabetes to assess the absence of dorsalis pedis and posterior tibial pulses as predictors of major macrovascular and microvascular events, death, and cognitive decline.

The researchers found that after multiple adjustment, compared with present pulses, absent pulses correlated with increased 5-year risks for major macrovascular events (hazard ratio (HR), 1.47), myocardial infarction (HR, 1.45), stroke (HR, 1.57), cardiovascular death (HR, 1.61), heart failure (HR, 1.49), all-cause mortality (HR, 1.48), major microvascular events (HR, 1.17), nephropathy (HR, 1.24), end-stage renal disease, or renal death (HR, 2.04), and peripheral neuropathy (HR, 1.13). Comparable hazard ratios were seen for participants with absent dorsalis pedis or posterior tibial pulses. There were proportional increases in risks in association with the number of absent peripheral pulses, with the highest risks seen for 3 or 4 absent pulses. The risks of all outcomes were increased with every additional absent pulse.

"These simple clinical indicators should be used to improve risk stratification and treatment of these patients," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Source

1. Mohammedi K, Woodward M, Zoungas S, et al. Absence of Peripheral Pulses and Risk of Major Vascular Outcomes in Patients With Type 2 Diabetes. Diab Care 2016 Sep; dc161594. doi:10.2337/dc16-1594.

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