Atherosclerotic Cardiovascular Disease Risk Among Patients with Type 2 Diabetes in Uganda

Abstract

While atherosclerotic cardiovascular disease risk is increased in patients with type 2 diabetes, the magnitude and socio-demographic determinants of this risk are not known in Uganda. We aimed to establish the magnitude of the predicted 10-year atherosclerotic cardiovascular risk and describe its socio-demographic determinants among patients with type 2 diabetes in Uganda. This was a cross-sectional study conducted in eight (8) diabetes clinics from November 2020 to February 2021. We enrolled 500 patients with type 2 diabetes aged between 40 to 79 years. Patients were interviewed on their socio-demographic characteristics. Anthropometric and laboratory measurements were performed. The predicted 10-year atherosclerotic cardiovascular risk was categorized using the Pooled Cohorts Risks Equations. Bivariate and multivariate logistic regression was conducted to establish associated socio-demographic factors. The majority of participants were females (78%), with a mean age of 55.14years (SD±8.96). Of the patients studied, 20% were at low risk (score <5%), 14.2% borderline risk (score 5-≤7.5%), 45.2% intermediate risk (score7.5-<20) and 20.6% high risk (score ≥20%). Elevated risk of score ≥7.5% was found in 65.8%. The male gender (AOR= 5.456, 95% CI 2.998-9.932, p=0.001), at least 50 years of age (AOR=7.841 95% CI 4.863-12.642, p=0.001), part-time employment (AOR=1.726, 95% CI 1.221-2.441, p=0.002) and being widowed (AOR=2.4, 95% CI 1.192-4.833, p=0.002) were significantly associated with cardiovascular disease risk. The cardiovascular disease risk among patients with type 2 diabetes is high. The male gender, age of at least 50years, part-time employment, and being widowed are socio-demographic factors that should be prioritized at primary level management of cardiovascular disease.

Atherogenic index of plasma and its cardiovascular risk factor correlates among patients with type 2 diabetes in Uganda

“…We have earlier shown that 65.8% of patients with T2D have a high 10 year predicted ASCVD risk 16 as determined with the Pooled Cohorts Risks Equation and the current study has shown that 56.4% of our patients have elevated AIP. The 10 -year predicted ASCVD risk assesses the global ASCVD risk i.e., coronary heart disease, ischaemic stroke and peripheral arterial disease risk while AIP is mainly a predictor of coronary artery disease 26 , which is the main cause of morbidity and mortality among the CVD spectrum in patients with T2D.…”

“…This was a cross-sectional study conducted in eight (8) diabetes clinics in Central-Uganda namely; Entebbe grade B hospital, Mengo Hospital, Naguru Hospital, Kasangati Health Center IV, Wakiso Health Center IV, Mpigi Health Center IV, Mityana Hospital and Kawolo Hospital. Detailed description of the methodology has been published elsewhere 16 . The study was approved by Mengo Hospital Research and Ethics Committee (Approval number MH/REC/100/9-2019) and was registered by Uganda National Council of Science and Technology (Registration number HS2738).…”