SAJDVD: VOLUME 15, ISSUE
2, NOVEMBER
2018
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- From the Editor’s Desk
Authors: Mahomed, FA
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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- Prevalence of cardiometabolic risk
factors among professional male long-distance
bus drivers in Lagos, south-west Nigeria: a
cross-sectional study Casmir E
Authors: Casmir E Amadi, Tim P Grove, Amam C Mbakwem, Obianuju B Ozoh, Oyewole A Kushimo, Davidavid A Wood, Michael Akinkunmi
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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Background: Professional drivers are known to be at high risk of cardiovascular disease (CVD). This study was carried out to highlight these risk factors and their predictors among male long-distance professional bus drivers in Lagos, southwest Nigeria, with a view to improving health awareness in this group.
Methods: Socio-demographic data, anthropometric indices, blood pressure, fasting plasma blood glucose levels and lipid and physical activity profiles of 293 drivers were measured.
Results: Mean age of the study population was 48 ± 9.7 years; 71.0 and 19.5% of the drivers used alcohol and were smokers, respectively; and 50.9% were physically inactive. The prevalence of overweight and obesity was 41.7 and 21.1%, respectively, while 39.7 and 13.9% were hypertensive and diabetic, respectively. Ninety (31.3%) subjects had impaired fasting glucose levels while 56.3% had dyslipidaemia. Predictors of hypertension were age and body mass index (BMI). BMI only was a predictor of abnormal glucose profile.
Conclusion: Professional male long-distance bus drivers in this study showed a high prevalence of a cluster of risk factors for CVD.
- The effects of treatment with atorvastatin versus rosuvastatin on
endothelial dysfunction in patients with hyperlipidaemia
Authors: Vahit Demir, Mehmet Tolga Doğru, Hüse yin Ede, Samet Yılma z, Cağlar Alp, Yunus Celik, Neslig ül Yıldırım
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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Introduction: Statins can reduce cardiovascular events and improve endothelial function. However, differences in the effect of statins on endothelial dysfunction have not been researched sufficiently. Here, we aimed to compare the effects of atorvastatin versus rosuvastatin on endothelial function via flow-mediated and endothelial-independent dilation.
Methods: Hyperlipidaemic subjects on treatment with statins for one year (either 20 mg/day atorvastatin or 10 mg/day rosuvastatin) were enrolled in the study. In accordance with the literature, flow-mediated dilation (FMD) and nitrate-mediated endothelium-independent dilation (EID) were measured by ultrasonography on the right brachial artery of each subject. Baseline and final measurements were compared in each group and between the groups.
Results: One hundred and four subjects (50 atorvastatin and 54 rosuvastatin users) were enrolled in the study. Fifty-eight subjects were female. The groups were statistically similar in terms of age and body mass index, and haemoglobin, creatinine, total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein cholesterol levels. In each group, the mean final FMD and EID values were higher compared to their respective baseline values, but the mean changes in FMD and EID were statistically similar in both groups (p = 0.958 for FMD and 0.827 for EID). There was no statistically significant difference between the atorvastatin and rosuvastatin groups in terms of final FMD and EID values (p = 0.122 and 0.115, respectively).
Conclusion: This study demonstrated that both one-year atorvastatin and rosuvastatin treatments significantly improved endothelial function, when assessed with FMD and EID and measured by ultrasonography. However, the amount of improvement in endothelial dysfunction was similar in the two treatments.
- Hypertension among newly diagnosed diabetic patients at Mulago
National Referral Hospital in Uganda: a cross sectional study
Authors: Martin artin Muddu, Edrisa Mutebi, Isaac Ssinabul ya, Samuel Kizito, Charles Kii za Mondo
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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Background: The prevalence of hypertension in patients with diabetes is approximately two-fold higher than in age-matched subjects without the disease and, conversely, individuals with hypertension are at increased risk of developing diabetes compared with normotensive persons. Up to 75% of cases of cardiovascular disease (CVD) in patients with diabetes are attributed to hypertension. Diabetics who have hypertension are more likely to develop complications and die, and appropriate blood pressure control in these individuals reduces the risk. This study sought to determine the prevalence and factors associated with hypertension among newly diagnosed adult diabetic patients in a national referral hospital in Uganda.
Methods: In this cross-sectional study, conducted between June 2014 and January 2015, we recruited 201 newly diagnosed adult diabetic patients. Information on patients’ socio-demographics was obtained using a pre-tested questionnaire, while biophysical profile, blood pressure measurement, biochemical testing and echocardiographic findings were obtained by the research team for all the participants. Bivariate and multivariate logistic regression analyses were used to investigate the association of several factors with hypertension.
Results: Of the 201 patients recruited, 102 were male (50.8%) and the mean age was 46 ± 15 years. The majority of patients (159) had type 2 diabetes mellitus (DM) (79.1%) with a mean HbA1c level of 13.9 ± 5.3%. The prevalence of hypertension was 61.9% (95% CI: 54.8–68.6%). Knowledge of hypertension status was at 56 (27.7%) patients, 24 (44.4%) hypertensives were on treatment, and 19 (33.9%) were using ACE inhibitors/angiotensin receptor blockers. The independent factors associated with hypertension were being employed (OR 0.37, 95% CI: 0.16–0.90, p = 0.029) and being overweight or obese (OR 11.6, 95% CI: 4.29–31.2, p < 0.0001).
Conclusion: The prevalence of hypertension was high in this population of newly diagnosed diabetics, few patients had knowledge of their hypertension status and few were on appropriate treatment. Both modifiable and non-modifiable risk factors were associated with hypertension in this group. Therefore routine assessment, treatment and control of hypertension among diabetics is necessary to prevent cardiovascular complications and death. There is also a need to address the modifiable risk factors.
- Association of microalbuminuria with left ventricular dysfunction in
Nigerian normotensive type 2 diabetes patients
Authors: TT Shogade, IO Essien, UE Ekrikpo, IO Umoh, CT Utin, BC Unadike, JJ And y
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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Background: Diabetes mellitus (DM) is a risk factor for left ventricular (LV) dysfunction, and microalbuminuria is frequently associated with DM. This study aimed to compare LV function among normotensive type 2 diabetes (T2DM) patients with normoalbuminuria, those with micro-albuminuria, and healthy controls.
Methods: This was a cross-sectional study conducted at the diabetes and cardiology clinics of the University of Uyo Teaching Hospital, Uyo, Akwa-Ibom State, Nigeria, from January 2013 to March 2014. Microalbuminuria was tested for using Micral test strips, and echocardiography-derived indices of LV function were compared among the three groups.
Results: Sixty-three normoalbuminuric, 71 microalbuminuric T2DM patients and 59 healthy controls were recruited. Mean age of participants was 50 ± 8 years and the three groups were age and gender matched (p = 0.23, p = 0.36, respectively). LV diastolic dysfunction (LVDD) showed a stepwise increase from the healthy controls to the normoalbuminuric to the microalbuminuric T2DM patients (16.9 vs 61.9 vs 78.9%, respectively) (p < 0.001), while E/A ratio and fractional shortening showed a significant stepwise decrease (both p < 0.001). LV systolic dysfunction was rare among the three groups. Microalbuminuria showed a strong direct association with LVDD (OR 3.58, 95% CI: 1.99–6.82, p < 0.001). Age remained independently associated with LVDD (OR 1.10, 95% CI: 1.03–1.17, p = 0.003).
Conclusions: LV diastolic function was altered in Nigerian normotensive T2DM patients, and the presence of microalbuminuria with DM had additional effects on this abnormality. Early screening for DM and microalbuminuria could identify individuals with high cardiovascular risk and possibly abnormal LV function.
- SGLT-2 inhibitors in type 2 diabetes
Authors: Brian Rayner
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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- Roadmap to achieve 25% hypertension control in Africa by 2025
Authors: Anastase nastase Dzudie, Brian Rayner, Dike Ojji, Aletta letta E Schutte, Marc Twagirumukiwagirumuki za, Albertino lbertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Anzouan Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa liwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awadwad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter oulter, Bongani Mayosi, on behalf of the PASCAR tasktask force on hypertension pertension
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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Background and aim: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority for action to reduce heart disease and stroke on the continent. The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025.
Methods: Development of this roadmap started with the creation of a consortium of experts with leadership skills in hypertension. In 2014, experts in different fields, including physicians and non-physicians, were invited to join. Via face-to-face meetings and teleconferences, the consortium made a situation analysis, set a goal, identified roadblocks and solutions to the management of hypertension and customised the World Heart Federation roadmap to Africa.
Results: Hypertension is a major crisis on the continent but very few randomised, controlled trials have been conducted on its management. Also, only 25.8% of the countries have developed or adopted guidelines for the management of hypertension. Other major roadblocks are either government and health-system related or healthcare professional or patient related. The PASCAR hypertension task force identified a 10-point action plan to be implemented by African ministries of health to achieve 25% control of hypertension in Africa by 2025.
Conclusions: Hypertension affects millions of people in SSA and if left untreated, is a major cause of heart disease and stroke. Very few SSA countries have a clear hypertension policy. This PASCAR roadmap identifies practical and effective solutions that would improve detection, treatment and control of hypertension on the continent and could be implemented as is or adapted to specific national settings.
- News from the 2018 Cape Town World
Congress of Internal Medicine
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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- How to deal with the mass killer, hypertension
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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- Evolving evidence about diet and health
From: South African Journal of Diabetes and Vascular Disease, Vol 15, Issue 2, Nov 2018
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LATEST EDITORS' CHOICE
Interesting
features, including:
- Cardiometabolic risk factors in male long-distance bus drivers
- Endothelial dysfunction in patients with hyperlipidaemia
- Hypertension in newly diagnosed diabetic patients in Uganda
- Microalbuminuria and left ventricular dysfunction in type 2 diabetes
- SGLT-2 inhibitors in type 2 diabetes: protecting kidney and heart
- African roadmap: 25% hypertension control in Africa by 2025
RELIABLE EXPERT INFORMATION
The SAJDVD’s main focus is
providing new and relevant information for doctors,
nurses and allied professionals involved in caring
for the diabetes patient.
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
But as we are part of the larger Diabetes team, we would like to reach out to all patients with relevant information. So here it is!
