Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes

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Authors: Ponirakis G, Petropoulos IN, Alam U, Ferdousi M, Asghar O, Marshall A, Azmi S, Jeziorska M, Mahfoud ZR, Boulton AJM, Efron N, Nukada H, Malik RA
Publication: American journal of hypertension
Year: 2019
Link: https://www.ncbi.nlm.nih.gov/pubmed/31013342

BACKGROUND:

Diabetic peripheral neuropathy (DPN) can lead to foot ulceration and amputation. There are currently no disease-modifying therapies for DPN. The aim of this study was to determine if hypertension contributes to DPN in patients with type 1 diabetes mellitus (T1DM).

METHODS:

Subjects with T1DM (n = 70) and controls (n = 78) underwent a comprehensive assessment of DPN.

RESULTS:

Hypertension was present in 40 of 70 T1DM subjects and 20 of 78 controls. Hypertension was associated with abnormal nerve conduction parameters (P = 0.03 to <0.001), increased vibration perception threshold (P = 0.01) and reduced corneal nerve fiber density and length (P = 0.02) in subjects with T1DM. However, after adjusting for confounding factors only tibial compound motor action potential and nerve conduction velocity were associated with hypertension (P = 0.03) and systolic blood pressure (P < 0.01 to <0.0001). Hypertension had no effect on neuropathy in subjects without diabetes.

CONCLUSIONS:

This study shows that hypertension is associated with impaired nerve conduction in T1DM. It supports previous small trials showing that angiotensin-converting enzyme inhibitors improve nerve conduction and advocates the need for larger clinical trials with blood pressure lowering agents in DPN.

  • Listing ID: 6678
  • Author/s: Ponirakis G, Petropoulos IN, Alam U, Ferdousi M, Asghar O, Marshall A, Azmi S, Jeziorska M, Mahfoud ZR, Boulton AJM, Efron N, Nukada H, Malik RA
  • Publication: American journal of hypertension
  • Year: 2019
  • Volume: 32
  • Issue: 8
  • Start Page: 796
  • Article Keywords: blood pressure; corneal confocal microscopy; diabetic peripheral neuropathy; hypertension; nerve conduction; quantitative sensory testing