Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes


Ponirakis, Georgios, Petropoulos, Ioannis N, Alam, Uazman ORCID: 0000-0002-3190-1122, Ferdousi, Maryam, Asghar, Omar, Marshall, Andrew ORCID: 0000-0001-8273-7089, Azmi, Shazli, Jeziorska, Maria, Mahfoud, Ziyad R, Boulton, Andrew JM et al (show 3 more authors) (2019) Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes AMERICAN JOURNAL OF HYPERTENSION, 32 (8). pp. 796-803. ISSN 0895-7061, 1941-7225

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Abstract

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.

Item Type: Article
Uncontrolled Keywords: blood pressure, corneal confocal microscopy, diabetic peripheral neuropathy, hypertension, nerve conduction, quantitative sensory testing
Depositing User: Symplectic Admin
Date Deposited: 15 May 2019 09:03
Last Modified: 22 May 2026 22:17
DOI: 10.1093/ajh/hpz058
Open Access URL: https://doi.org/10.1093/ajh/hpz058
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3041403
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