Exercise Stress Testing In Diabetics with Asymptomatic Coronary Artery Disease.

Background: Coronary artery disease (CAD) is a common cause of premature morbidity and mortality in diabetics and is often asymptomatic because of silent myocardial ischemia. Early detection of silent myocardial ischemia may prevent catastrophic cardiac events. Objectives: to study the prevalence of latent coronary artery disease in diabetics by maximal treadmill exercise testing and to correlate CAD with severity and duration of diabetes. Materials and methods: The present one year observational cross sectional study was conducted at Gurugobind Singh hospital, Jamnagar in 100 diabetic patients without clinical evidence of coronary artery disease. All participants undergone exercise stress testing using Bruce protocol to detect silent myocardial ischemia. Results: Out of 100 patients, TMT was positive in 32(32%) and negative in 68(68%) patients. TMT was positive in 10/56(17.85%), 8/24(33.33%), 8/12(66.66%) and 6/8(75%) patients with duration of diabetes ≤5, 6 to 10, 11 to 15 and 16 to 20 years respectively. Conclusion and interpretation: The prevalence of asymptomatic coronary artery disease in diabetes mellitus without past history of ischemic heart disease or hypertension is 32%. Longer the duration and poor control of diabetes, greater the risk of asymptomatic coronary artery disease.

Comparative study of serum lipid profile between prehypertensive and normotensive.

Background: Prehypertensive subjects have greater risk of developing hypertension than the normotensive subjects. Studies have shown that lipid profile is altered in hypertensive patients as compare to normotensive subjects. But not much is documented about lipid profile in prehypertensives. So the present study is done to compare the serum lipid profile among prehypertensive and normotensives and to correlate the blood pressure and lipid profile in prehypertensives. Methods: 50 prehypertensive and 50 normotensive subjects were recruited from the general population. Blood pressures were recorded and serum lipid profiles were measured and compare using student t test. Correlation of serum lipid profile and blood pressure was done using person correlation. Results: The study results showed significant increased in total cholesterol, LDL, VLDL and serum triglyceride level in prehypertensives compare to normotensives. While there is no significant change in HDL level in prehypertensive compare to normotensive. And there is also a significant correlation between blood pressure and lipid profile in prehypertensive subjects. Conclusion: Lipid profile is altered in prehypertensives compare to normotensives. That’s why timely diagnoses and life style modification is required in prehypertensives.