Peripheral artery disease and exertional leg symptoms in diabetes patients in Ghana

Yeboah, Kwame; Puplampu, Peter; Ainuson, J.K.; Akpalu, Josephine; Gyan, Ben; Amoah, Albert

doi:10.1186/s12872-016-0247-x

Cited by 21 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Peripheral arterial disease is a major health care problem in diabetes patients in Ghana. We reported previously that the prevalence of PAD in diabetes patients in Ghana was 26.7%, using Doppler measured ABI [ 14 ]. In sub-Saharan Africa, ABI is not routinely performed to diagnose PAD, even in high-risk diabetes patients.…”

Section: Discussionmentioning

confidence: 99%

“…PAD, therefore, is clinically underrecognized, and management is initiated when associated with symptomatic exertional leg pain. However, most patients with PAD are asymptomatic, and, hence, relying on symptoms before initiating treatment may be less advantageous [ 2 , 14 ]. Moreover, the presence of PAD indicates generalised atherosclerosis in such patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Circulating Angiogenic Growth Factors in Diabetes Patients with Peripheral Arterial Disease and Exertional Leg Pain in Ghana

Agyekum

Kyei-Baafour

Antwi

et al. 2017

International Journal of Vascular Medicine

Self Cite

View full text Add to dashboard Cite

Objective Peripheral arterial disease (PAD) is a common complication of diabetes, associated with impairment in angiogenesis. Angiogenesis is regulated by angiogenic growth factors such as angiopoietin 1 (Ang-1), Ang-2, and vascular endothelial growth factor (VEGF). We studied the association between angiogenic growth factors versus PAD and exertional leg symptoms in diabetes patients in Ghana. Method In this cross-sectional study, ankle-brachial index was measured with oscillometrically and exertional leg symptoms were screened with Edinburgh claudication questionnaire in 140 diabetes patients and 110 nondiabetes individuals. Circulating levels of Ang-1, Ang-2, and VEGF were measured with immunosorbent assay. Results The prevalence of PAD and exertional leg pain was 16.8% and 24.8%, respectively. Compared to non-PAD participants, PAD patients had higher VEGF levels [85.8 (37.5–154.5) versus 57.7 (16.6–161.1) p = 0.032] and lower Ang-1 levels [31.3 (24.8–42.6) versus 40.9 (28.2–62.1), p = 0.017]. In multivariable logistic regression, patients with exertional leg pain had increased the odds of plasma Ang-2 levels [OR (95% CI): 2.08 (1.08–6.41), p = 0.036]. Conclusion Diabetes patients with PAD and exertional leg pain have imbalance in angiogenic growth factors, indicating impaired angiogenesis. In patients with exertional leg pains, Ang-2 may be an important biomarker.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Circulating Angiogenic Growth Factors in Diabetes Patients with Peripheral Arterial Disease and Exertional Leg Pain in Ghana

Agyekum

Kyei-Baafour

Antwi

et al. 2017

International Journal of Vascular Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Currently, noncommunicable diseases (NCDs) like metabolic syndrome (MetS) are said to be rising alarmingly in the Ghanaian population particularly among females [1,2] and there are fears that this could worsen in the not-too-distant future because current data is suggestive that young adults with parental history of hypertension have increased risk for MetS [2]. Nurses are influential members of the healthcare team and could play a critical role reversing this rising burden of NCDs [3].…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension is now classified as a public health emergency in Sub-Saharan Africa (SSA) [2,5] and it is the leading risk factor for cardiovascular morbidity and mortality [1,2]. In Ghana, hypertension accounts for 4% of all Out-Patient Department (OPD) attendance and 4.6% of all deaths [12].…”

Section: Introductionmentioning

confidence: 99%

Expectation and Satisfaction with Nursing Care among Hypertensives Receiving Care at a Resource-Constrained Hospital in Ghana

Konlan

Armah-Mensah

Aryee

et al. 2020

Nursing Research and Practice

View full text Add to dashboard Cite

Background. Hypertension accounts for a third of the global preventable premature deaths. In Sub-Saharan Africa, hypertension is the most rapidly increasing cardiovascular disease (CVD) and the second leading cause of death. Proper management of hypertension requires adherence to management by patients and this is partly possible if patients feel satisfied with the nursing care they receive. Satisfaction with nursing care is only possible if there is a congruence between the expectations of care and the actual care received from nurses. Aim. We explored the expectations and satisfaction of Ghanaian hypertensives with nursing care received at the Korle-Bu Teaching Hospital (KBTH). Methods. In this qualitative study, a phenomenological approach was used to gather data about the lived experiences of patients with hypertension about nursing care. In-depth interviews (IDIs) were conducted among sixteen (16) patients with hypertension from the hypertensive Out-Patient Department (OPD) Clinics of the Medical Department at the KBTH. Only patients with history of previous admission(s) at the KBTH during the immediate past six months were purposively recruited. The respondents were interviewed about the nursing care received during their immediate past admission(s) at the KBTH using an IDI-guide. The IDIs were recorded digitally, transcribed verbatim, and reviewed severally and thematic analysis was done. Nvivo 11 software was used to manage the data and aid with the thematic analysis. Results. The results of this study showed that Ghanaian hypertensive patients perceived nurses as key players in the management of patients. On the respondents’ expectations from nurses prior to their immediate past admissions at the KBTH, the data revealed the responsiveness of nurses to patient needs, prompt pain management, high confidentiality level of nurses, rendering of efficient health education, maintenance of therapeutic work environment, and ensuring effective communication as well as professional/ethical practice from the nurses. On the question of what made nursing care satisfying, it was observed from the respondents that they considered the competence of nurses, maintenance of therapeutic environment, and also effective handling of confidential information as determinants of their satisfaction with nursing care. Further, the respondents identified some key areas of dissatisfaction and these included the responsiveness of nurses to patient needs, prompt pain management, effectiveness of health education, and provision of culturally sensitive communication. Disproportionate distribution of nursing staff across the three nursing shifts, unethical practice among some nurses, inadequate resources for work, and low work morale of some nurses were identified as factors responsible for the gaps between patient expectations and actual care received. Conclusion. Our study concludes that continuous professional development programs for nurses should focus on the areas of dissatisfaction so as to improve care for hypertensives. We also recommend that nursing staff distribution across the various shifts should be of keen interest to nurse managers if hypertension care in particular and overall patient care in general are to improve.

show abstract

“…Diabetes is now common in sub-Saharan African population and associated with macrovascular and microvascular complications [ 1 , 2 ]. Cardiovascular diseases are among the major causes of death in diabetes patients; however, studies have shown that microvascular disease is also associated with excess mortality [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Arterial Stiffness Is Associated with Peripheral Sensory Neuropathy in Diabetes Patients in Ghana

Agyekum

Mensah

Affrim

et al. 2018

Journal of Diabetes Research

Self Cite

View full text Add to dashboard Cite

Objective Peripheral sensory neuropathy (PSN) is among microvascular complications of diabetes that make patients prone to ulceration and amputation. Arterial stiffness is a predictor of cardiovascular diseases and microvascular complications associated with diabetes. We investigated the association between PSN and arterial stiffness, measured as aortic pulse wave velocity (PWVao) and cardio-ankle vascular index (CAVI). Method In a case-control design, arterial stiffness was measured in 240 diabetes patients and 110 nondiabetic control. Large-fibre nerve function was assessed by vibration perception threshold (VPT) using a neurothesiometer. PSN was defined as the VPT > 97.5th percentile from age- and gender-adjusted models in nondiabetic controls. Results The overall prevalence of PSN was 16.6% in the entire study participants. Compared to non-PSN participants, PSN patients had higher levels of PWVao (9.5 ± 1.7 versus 8.7 ± 1.2 m/s, p = 0.016) and CAVI (8.4 ± 1.3 versus 7.6 ± 1.1, p = 0.001). In multiple regression models, VPT was associated with PWVao (β = 0.14, p = 0.025) and CAVI (β = 0.12, p = 0.04). PSN patients had increased odds of CAVI (OR = 1.51 (1.02–2.4), p = 0.043), but not PWVao (OR = 1.25 (0.91–1.71), p = 0.173). Conclusion PWVao and CAVI were associated with VPT and PSN in diabetes patients in Ghana. Patients having PSN have increased odds of CAVI, independent of other conventional risk factors.

show abstract

Peripheral artery disease and exertional leg symptoms in diabetes patients in Ghana

Cited by 21 publications

References 34 publications

Circulating Angiogenic Growth Factors in Diabetes Patients with Peripheral Arterial Disease and Exertional Leg Pain in Ghana

Circulating Angiogenic Growth Factors in Diabetes Patients with Peripheral Arterial Disease and Exertional Leg Pain in Ghana

Expectation and Satisfaction with Nursing Care among Hypertensives Receiving Care at a Resource-Constrained Hospital in Ghana

Arterial Stiffness Is Associated with Peripheral Sensory Neuropathy in Diabetes Patients in Ghana

Contact Info

Product

Resources

About