Key result
Pulse pressure ≥65 mmHg is linked to ~163% higher heart failure risk in asymptomatic diabetics.
Why the study?
Although the association between diabetes and heart failure is known, data in Sub-Saharan Africa are limited.
Cross-Sectional (n=408)
No
Odds Ratio: 2.63 (95% CI 1.83–3.99)
p-value: p=<0.001
In asymptomatic diabetic patients in Sub-Saharan Africa, nearly 30% had elevated BNP indicative of heart failure, strongly associated with elevated pulse pressure, older age, female sex, and impaired renal function.
Elevated pulse pressure may flag heart failure risk in asymptomatic diabetics; cross-sectional data leave causal inference and screening utility open.
Background: The association between diabetes and heart failure is known in the literature, but data in Sub-Saharan Africa are limited. The objective of this study is to identify the clinical and hemodynamic factors associated with the incidence of heart failure in diabetics followed in Goma. Methods: Asymptomatic diabetics in the city of Goma were cross-sectionally recruited at the Center of the Association of Diabetics in Congo (ADIC) in Goma, DRC during the period from February 5 to 19, 2023. The risk of insufficiency heart rate at 5 years was determined using BNP. A BNP value ≥50 pg/ml was considered an incidence of heart failure. The association between the incidence of HF and the independent variables was assessed using the logistic regression test, the best performing blood pressure component of the incidence of heart failure was assessed by the ROC curve and the area under the curve. Results: The incidence frequency of heart failure was 29.98%. Analysis of the ROC curve showed that PP was the most important component of AP associated with a subsequent incidence of HF [AUC = 0.873; 95% CI: 0.829-0.916]. After adjusting for all these variables in a multiple logistic regression, age≥40 years (aOR: 2.02, 95% CI: 1.03-3.04) (p=0.024), female gender (aOR: 2.00, 95% IC: 1.24- 3.25) (p=0.005), PP≥65 mmHg (aOR: 2.63, 95% CI: 1.83-3.99) (p<0.001) and eGFR<60 mmHg (aOR: 1.99, 95% CI: 1.09-3.00) (p =0.037) were the independent risk factors associated with the incidence of HF in diabetics. Conclusion: The frequency of HF is high in asymptomatic diabetics in Goma. It is associated with gender, age, PP and altered eGFR.
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Mukoso et al. (2023) conducted a cross-sectional in Diabetes mellitus (n=408). Pulse pressure ≥ 65 mmHg vs. Pulse pressure < 65 mmHg was evaluated on Incidence of heart failure (BNP ≥ 50 pg/mL) (aOR 2.63, 95% CI 1.83-3.99, p=<0.001). Pulse pressure ≥ 65 mmHg was independently associated with a significantly increased risk of heart failure incidence in asymptomatic diabetic patients (aOR 2.63).
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