Further Investigation of the Negative Association between Hypertension and Peripheral Neuropathy in the Elderly: An Oklahoma Physicians Resource/Research Network (OKPRN) Study

Dong Yung Cho; James W. Mold; Michelle Roberts

doi:10.3122/jabfm.19.3.240

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Table 1.

Characteristics of Subjects Who Had No Diseases Known to Cause Peripheral Neuropathy (PN)* (N = 584)

Continuous Variables	PN(−) N = 436 Mean (SD)	PN(+) N = 148 Mean (SD)	T	P Value
Age	72.68 (5.50)	75.70 (6.55)	−5.02	<.0001
BMI	28.12 (5.01)	29.07 (5.86)	−1.76	.08
Orthostatic BP	13.46 (47.76)	13.11 (11.33)	0.14	.89
Pulse pressure	65.24 (17.89)	65.35 (17.96)	−0.07	.95
Diast BP(5 Rest)	76.17 (10.90)	75.01 (12.12)	1.02	.31
Diast BP(1 Stand)	75.85 (11.16)	73.94 (13.52)	1.54	.12
Diast BP(5 Stand)	76.30 (12.53)	74.65 (13.30)	1.31	.19
Syst BP(5 Rest)	141.55 (20.47)	140.36 (23.20)	0.55	.58
Syst BP(1 Stand)	138.73 (51.72)	135.00 (23.99)	1.17	.24
Syst BP(5 Stand)	136.51 (22.67)	136.60 (23.34)	−0.07	.95
Number of visits	4.32 (4.05)	4.68 (3.60)	−1.01	.31

Categorical Variables	State	PN(−)	PN(+)	χ²	P Value
Gender	Female	247	77	0.96	.32
	Male	189	71
Hypertension	(−)	240	94	3.24	.07
	(+)	196	54
Military service	(−)	293	90	2.00	.16
	(+)	143	58
Logistic Regression

Predictor Variables	Coefficient	Standard Error	P Value	Deviance (P Value)
Age	0.10	0.02	<.0001
BMI	0.06	0.02	.001	613.48
Hypertension	−0.51	0.21	.01	(P = .11)

* PN, peripheral neuropathy; BMI, body mass index(kg/m²); pulse pressure, systolic blood pressure − diastolic blood pressure; Diast BP(1St), diastolic blood pressure 1 min after standing position; Diast BP(5Res), diastolic blood pressure 5 min after rest; Diast BP(5St), diastolic blood pressure 5 min after standing position; Syst BP(1St), systolic blood pressure 1 min after standing position; Syst BP(5Res), systolic blood pressure 5 min after rest; Syst BP(5St), systolic blood pressure 5 min after standing position; Orthostatic BP, Syst BP(1St) − Syst BP(5Res) ; number of visits, number of clinic visits; (+), positive history; (−), negative history.

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Table 2.

Characteristics of Subjects Who Had No Diseases Known to Cause Peripheral Neuropathy and Who Were Still Enrolled in the Third Year of the Study (N = 287)

Continuous Variables	PN(−) N = 225 Mean (SD)	PN(+) N = 62 Mean (SD)	T	P Value
Age	72.90 (5.56)	72.77 (5.16)	0.17	.87
BMI	28.11 (4.79)	29.93 (6.10)	−2.16	.03
Pulse pressure	64.13 (17.93)	63.81 (15.15)	0.14	.89
Otho BP	11.50 (0.92)	13.60 (11.06)	−1.25	.21
Diast BP(5 Rest)	75.03 (10.43)	75.45 (11.97)	−0.25	.80
Diast BP(1 Stand)	74.55 (11.07)	75.90 (14.21)	−0.69	.49
Diast BP(5 Stand)	74.69 (12.38)	76.30 (13.29)	−0.85	.40
Syst BP(5 Rest)	139.16 (19.22)	139.26 (21.32)	−0.03	.97
Syst BP(1 Stand)	133.25 (21.94)	135.05 (23.00)	−0.55	.59
Syst BP(5 Stand)	134.44 (20.46)	135.41 (21.41)	−0.32	.75

Categorical Variables	State	PN(−)	PN(+)	χ²	P Value
Gender	Female	124	30	0.88	.35
	Male	101	32
Hypertension	(−)	134	37	0.00	.99
	(+)	91	25
ACE-I & ARB^*	(−)	181	49	0.06	.81
	(+)	44	13
α blocking agents	(−)	207	56	0.18	.67
	(+)	18	6
β blocking agents	(−)	209	49	10.27	.001
	(+)	16	13
Calcium channel block	(−)	203	55	0.12	.73
	(+)	22	7
Diuretics	(−)	187	48	1.06	.30
	(+)	38	14
Vasodilators	(−)	218	62	1.98	.16
	(+)	7	0
NSAIDs	(−)	190	42	8.75	.003
	(+)	35	20
Military service	(−)	146	36	0.98	.32
	(+)	79	26
Number of medications	0	138	30	3.61	.16
	1	45	15
	2 or more	42	17
Logistic Regression

Predictor Variables	Coefficient	Standard Error	P Value	Deviance (P Value)
BMI	0.05	0.03	.07
β-blocking agents	1.29	0.42	.002	277.20
NSAID	0.84	0.34	.01	(P = .52)

* ACE-I & ARB, angiotensin-converting enzyme inhibitor and angiotensin receptor blocker; BMI, body mass index; NSAIDs, nonsteroidal antiinflammatory drugs.

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Table 3.

Associations between Use of β Blockers or NSAIDs* and Specific Neurological Deficits after Controlling for Age and BMI in Subjects Who Had no Diseases Known to Cause Peripheral Neuropathy and Who Were Still Enrolled in Year 3 of the Study (N = 287)*

	Predictor Variables	Coefficient	Standard Error	P Value
PN(ankle)^†	BETA	1.24	0.43	0.004
(N = 50)	NSAID	0.50	0.37	0.18
PN(touch)	BETA	0.23	0.80	0.77
(N = 16)	NSAID	1.21	0.54	0.02
PN(position)	BETA	1.90	0.97	0.05
(N = 5)	NSAID	1.93	0.96	0.04
PN(vibration)	BETA	1.44	0.95	0.13
(N = 7)	NSAID	3.27	1.07	0.002

* Statistical analysis was done by logistic regression.
† PN(ankle), subjects who had deficit in ankle reflex; PN(touch), subjects who had deficit in touch sensation; PN(position), subjects who had deficit in position sensation; PN(vibration), subjects who had deficit in vibration sensation.

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Table 4.

Characteristics of Subjects with Diabetes Mellitus (N = 110)

Continuous Variables	PN(−) N = 62 Mean (SD)	PN(+) N = 48 Mean (SD)	T	P Value
Age	71.98 (5.73)	71.73 (4.55)	0.26	.80
BMI	29.38 (5.69)	33.51 (7.40)	−3.16	.002
Orthostatic BP	12.45 (10.51)	15.21 (18.11)	−0.94	.35
Pulse Pressure	67.81 (15.43)	72.88 (22.74)	−1.33	.19
Syst BP(5Res)	141.97 (20.42)	148.79 (28.86)	−1.39	.17
Syst BP(1St)	139.06 (25.16)	142.25 (34.94)	−0.53	.60
Syst BP(5St)	137.71 (22.22)	143.63 (33.96)	−1.05	.30
Diast BP(5Res)	74.16 (11.67)	75.92 (13.48)	−0.72	.47
Diast BP(1St)	72.16 (13.37)	71.92 (18.72)	0.08	.94
Diast BP(5St)	73.77 (14.81)	73.08 (19.58)	0.20	.84

Categorical Variables	State	PN(−)	PN(+)	χ²	P Value
Gender	Female	30	22	0.07	.79
	Male	32	26
Hypertension	(−)	21	23	2.22	.14
	(+)	41	25
Military service	(−)	42	25	2.79	.10
	(+)	20	23
Logistic Regression

Predictor Variables	Coefficient	Standard Error	P Value	Deviance (P Value)
BMI	0.44	0.17	.01
Pulse pressure	0.19	0.08	.02
Military service	5.45	2.11	.009	114.71
Hypertension	−1.07	0.50	.03	(P = .13)
Pulse pressure× military service	−0.07	0.03	.02
BMI× pulse pressure	−0.004	0.002	.05

PN, peripheral neuropathy; BMI, body mass index; BP, blood pressure.

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Table 5.

Characteristics of Subjects with Diabetes Mellitus Who Were Still Enrolled in the Third Year of the Study (N = 45)

Continuous Variables	PN(−) N = 25 Mean (SD)	PN(+) N = 20 Mean (SD)	T	P Value
Age	71.32 (5.55)	71.15 (4.30)	0.12	.91
BMI	28.97 (4.77)	35.58 (7.40)	−3.36	.002
Pulse pressure	63.28 (16.15)	75.00 (25.39)	−1.79	.08
Otho BP	14.00 (10.23)	15.10 (25.66)	−0.18	.86
Diast BP(5 Rest)	73.84 (10.98)	77.20 (14.38)	−0.86	.39
Diast BP(1 Stand)	71.76 (12.80)	71.70 (24.45)	0.01	.99
Diast BP(5 Stand)	73.12 (12.78)	71.30 (24.74)	0.30	.77
Syst BP(5 Rest)	137.12 (19.12)	152.20 (33.14)	−1.81	.08
Syst BP(1 Stand)	135.92 (24.49)	143.10 (45.15)	−0.64	.53
Syst BP(5 Stand)	130.16 (17.59)	142.60 (45.63)	−1.15	.26

Categorical Variables	State	PN(−)	PN(+)	χ²	P Value
Gender	Female	10	7	0.12	.73
	Male	15	13
Hypertension	(−)	9	10	0.89	.34
	(+)	16	10
ACE-I & ARB	(−)	16	11	0.38	.54
	(+)	9	9
α blocking agents	(−)	21	19	1.36	.24
	(+)	4	1
β blocking agents	(−)	19	15	0.01	.94
	(+)	6	5
CCB	(−)	22	11	6.19	.01
	(+)	3	9
Diuretics	(−)	21	12	3.27	.07
	(+)	4	8
Vasodilators	(−)	24	18	0.64	.42
	(+)	1	2
NSAIDs	(−)	22	18	0.05	.83
	(+)	3	2
Military service	(−)	16	8	2.57	.11
	(+)	9	12
Number of medications	0	10	4	4.72	.09
	1	8	4
	2 or more	7	12
Logistic Regression

Predictor Variables	Coefficient	Standard Error	P Value	Deviance (P Value)
BMI	0.32	0.12	.005
Military Service	3.44	1.46	.02	27.78
Syst BP(5 Rest)	0.05	0.02	.02	(P = .86)
CCB	3.28	1.54	.03

PN, peripheral neuropathy; ACE-I & ARB, angiotensin-converting enzyme inhibitor and angiotensin receptor blocker; BMI, body mass index; NSAIDs, nonsteroidal antiinflammatory drugs. CCB, calcium channel blocker; BP, blood pressure.