Diabetes, Hypertension and Metabolic Syndrome

Diabetes and Vascular Disease

Lower extremity arterial disease (LEAD) is clinically identified by intermittent claudication and/or absence of peripheral pulses in the lower legs and feet. These clinical manifestations reflect decreased arterial perfusion of the extremity. With the use of Doppler technology and blood pressure measurements of the extremity, LEAD can be identified noninvasively before clinical manifestation. X-ray of the extremities can detect arterial calcification that is indicative of arterial disease with or without an occlusive component. The incidence and prevalence of LEAD increase with age in both diabetic and nondiabetic subjects and, in those with diabetes, increase with duration of diabetes. Many elderly diabetic persons have LEAD at the time of diabetes diagnosis. Diabetes is an important risk factor for LEAD. Hypertension, smoking, and hyperlipidemia, which are frequently present in patients with diabetes, contribute additional risk for vascular disease.