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Comparative studies on vascular disorders in diabetics between urban and rural districts
Insights
Rural diabetics experienced twice the rate of heart attack and stroke compared to urban diabetics. This was linked to higher rates of hypertension and abnormal ECGs, not blood sugar or cholesterol levels.
Area of Science:
- Cardiology
- Endocrinology
- Epidemiology
Background:
- Diabetes mellitus is a significant risk factor for vascular complications.
- Urban and rural populations may exhibit different risk factor profiles for diabetes-related comorbidities.
Purpose of the Study:
- To compare the incidence of vascular disorders between diabetic patients residing in urban and rural districts.
- To identify potential contributing factors to observed differences in vascular disease incidence.
Main Methods:
- Comparative analysis of vascular disorder incidence in two distinct diabetic cohorts: urban (group-U, n=408) and rural (group-R, n=148).
- Assessment of key cardiovascular risk factors including hypertension, ECG abnormalities, and metabolic markers (HbA1, lipid profile).
Main Results:
- Rural diabetics (group-R) exhibited approximately double the annual incidence rates of myocardial infarction and cerebrovascular disease compared to urban diabetics (group-U).
- Significantly higher prevalence of hypertension (p < 0.01) and ECG abnormalities were observed in group-R.
- No significant differences were found in the incidence of proteinuria or proliferative retinopathy, nor in age, obesity, HbA1, or lipid profiles between the groups.
- The duration of diabetes was shorter in the rural group.
Conclusions:
- Elevated rates of myocardial infarction and cerebrovascular disease in rural diabetics are strongly associated with higher prevalence of hypertension and ECG abnormalities.
- These vascular complications in the rural cohort do not appear to be influenced by differences in glycemic control (HbA1) or serum lipid levels.
- Hypertension and ECG abnormalities are likely key drivers of increased vascular risk in this rural diabetic population.
Abstract:
The incidence of vascular disorders was investigated in two groups of diabetics. One group (group-U) comprised 408 diabetics who were inhabitants of an urban district. The other group (group-R) consisted of 148 diabetics who were inhabitants of a rural district. The annual incidence rates of myocardial infarction and cerebrovascular disease in group-R were about twice as high as the respective rates in group-U. The prevalence rates of hypertension and ECG-abnormalities in group-R were also significantly higher than those in group-U (p less than 0.01). However, there was no appreciable difference between the two groups with respect to the incidence of proteinuria or proliferative retinopathy. Any significant difference between the two groups in age, obesity index, Hb-A1, T. Chol., TG. or HDL-C levels was not recognized. The duration of diabetes was relatively short in group-R. These findings suggest that the high incidence of myocardial infarction and cerebrovascular disease in group-R is not influenced by the difference in Hb-A1 or serum lipid levels, and that these vascular disorders are probably associated with hypertension and ECG-abnormalities.