The diagnostic utility of inflammatory markers in the evaluation of cardiovascular risk among Ghanaians presenting with type 2 diabetes and hypertension

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DECEMBER, 2014
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Abstract
It is suggested that inflammation is associated with hypertension and type 2 diabetes occurring either before or as a consequence of the development of these diseases. Hence inflammation measurement may provide additional information regarding a person’s risk of cardiovascular morbidity and type 2 diabetes or contribute to the understanding of the pathogenesis of these diseases. This study sought to explore the utility of inflammatory markers in evaluating cardiovascular risk in Ghanaian type 2 diabetes and hypertensive subjects attending the Battor Catholic Hospital in the Volta Region. It also sought to determine the relative risk of developing cardiovascular disease among the different groups in the study population. This case-control study was conducted between December 2012 and February 2013, involving 125 participants comprising 43 hypertensives, 40 type 2 diabetics and 42 with both conditions. The control group consisted of 62 age-matched healthy individuals in the study area. Socio-demographic variables were obtained using a semi-structured questionnaire whiles other study parameters were obtained using standard methods. Inflammation was found to be associated with hypertensive and type 2 diabetic subjects recording higher levels of inflammatory markers (hs-CRP, IL-6, ESR and WBC) with the exception of TNF-α. Type 2 diabetes and hypertensive subjects also recorded significantly higher cardiometabolic risk profiles compared to their control peers. Twenty- five percent (25%) of participants had a high risk of developing coronary disease over the next ten years. The percentage risk in general was higher in type 2 diabetes and hypertensive subjects compared to the healthy population. Gender variation in percentage ten year risk was observed with significant proportion of women recording high risk than men. Measurement of inflammation may be useful to identify cohorts of patients for clinical iv trials to determine whether reduction/inhibition of hs-CRP reduces CHD events. Further studies could expand the scope of biomarkers of inflammation and endothelial dysfunction, compare oxidised LDL-Cholesterol levels between type 2 diabetes and hypertensive individuals with their healthy counterparts in evaluating their future cardiovascular risk. The sample size could also be increased substantially so that a generalised conclusion could be made among the Ghanaian population
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A thesis submitted to the Department of Molecular Medicine,College of Health Sciences, in partial fulfillment of the requirements for the degree of Master of Philosophy.
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