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.

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<h4>Background</h4>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).<h4>Methods</h4>Subjects with T1DM (n = 70) and controls (n = 78) underwent a comprehensive assessment of DPN.<h4>Results</h4>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.<h4>Conclusions</h4>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: 28 Jan 2023 01:53
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