Pulse pressure and prediction of incident foot ulcers in type 2 diabetes.
OBJECTIVE
To assess the relevance of pulse pressure as a predictor of foot ulcers in type 2 diabetic subjects.


METHODS
A cohort study was performed on a consecutive series of 1,945 type 2 diabetic outpatients without a foot ulcer at baseline. Incident foot ulcers were identified through the regional hospital discharge system, which contains ICD codes of current diagnoses.


RESULTS
During a follow-up of mean +/- SD 4.2 +/- 2.2 years, 86 ulcers were observed. After adjusting for confounders, the highest quartiles of pulse pressure had a 2.39-fold (95% CI 1.14-5.02) risk of foot ulcers. When ischemic ulcers were considered separately, the highest pulse pressure quartile was associated with an increased age- and sex-adjusted risk (2.08 [95% CI 1.02-4.24]), whereas no increase of risk was observed for neuropathic ulcers.


CONCLUSIONS
Elevated pulse pressure represents an independent predictor of foot ulcers in diabetic patients; this parameter should be considered for the stratification of risk of ischemic or neuroischemic ulcers.
Monami
Matteo
M
Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy. mmonami@libero.it
Vivarelli
Maria
M
Desideri
Carla Maria
CM
Colombi
Claudia
C
Marchionni
Niccolò
N
Mannucci
Edoardo
E
D017668:Age of Onset; D000368:Aged; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D017719:Diabetic Foot / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors
D007004:Hypoglycemic Agents