Lower extremity peripheral artery disease: prevalence and risk factors among adult Nigerians with diabetes mellitus.

Background: Diabetes mellitus is an important risk factor for development of atherosclerosis. Lower extremity peripheral artery disease (LEAD) which is mainly due to atherosclerosis has been associated with not only increased risk of lower limb amputation but also increased risk of morbidity and mortality from major cardiovascular events such as stroke and myocardial infarction. Information on the prevalence of peripheral vascular disease is scanty in Nigeria.
Objective: The aim of this study was to determine the prevalence of LEAD and risk factors associated with its development in adult Nigerians with type 2 diabetes mellitus.
Methods: The study was cross-sectional. Patients were consecutively enrolled in the study between August 2009 and May 2010 from the Consultant out-patient department, University of Benin Teaching Hospital, Benin-City, Nigeria. LEAD was assessed in all the patients using Ankle Brachial Index <0.9 in either leg. The Edinburgh Claudication Questionnaire was used to determine if patient had symptomatic disease or not.
Results: Three hundred and eighty eight diabetic patients were enrolled in the study out of which 244 (62.9%) were females. The study showed that the prevalence of LEAD was 35.6% when diagnosed using Doppler ABI <0.9 in either leg. The ratio of symptomatic to asymptomatic disease was 1: 7.6. Advancing age, duration of diabetes and concomitant hypertension were important risk factors significantly associated with the disease.
Conclusion: LEAD is not uncommon among type 2 diabetes patients in Nigeria and the majority were asymptomatic. Advancing age, duration of diabetes and concomitant hypertension were important risk factors identified.