Association of Coronary Microvascular Dysfunction With Cerebrovascular Risk and Cognitive Decline in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study

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Date: 03/06/2026
Abstract: Background: Type 2 diabetes mellitus is associated with microvascular complications that may contribute to both cardiovascular and neurological morbidity. Objective: To evaluate the association of coronary microvascular dysfunction with stroke risk, cognitive decline, and selected hematologic/metabolic biomarkers in patients with type 2 diabetes mellitus without major vessel occlusion. Methods: This analytical cross-sectional study was conducted at the Department of Cardiology, Jinnah International Hospital, Abbottabad, Pakistan, from May 2025 to November 2025. A total of 255 patients with type 2 diabetes mellitus were enrolled using non-probability consecutive sampling. Coronary microvascular dysfunction was assessed through clinical evaluation and available cardiovascular investigations in patients without significant epicardial coronary artery obstruction. Results: The mean age of the participants was 54.7 ± 10.9 years, and 146 (57.3%) were male. Coronary microvascular dysfunction was identified in 112 (43.9%) patients. Cognitive decline was significantly more frequent among patients with coronary microvascular dysfunction than those without it (46.4% vs. 29.4%, p = 0.006). Elevated stroke risk was also higher in patients with coronary microvascular dysfunction (43.8% vs. 23.1%, p = 0.001). Patients with coronary microvascular dysfunction had longer diabetes duration (10.1 ± 4.3 vs. 7.4 ± 3.6 years, p = 0.001), higher glycosylated hemoglobin levels (8.9 ± 1.6% vs. 7.8 ± 1.4%, p = 0.001), higher low-density lipoprotein cholesterol levels (142.1 ± 27.5 vs. 128.4 ± 28.7 mg/dL, p = 0.004), and greater frequencies of hypertension (63.4% vs. 46.9%, p = 0.012) and dyslipidemia (55.4% vs. 41.3%, p = 0.028). Conclusion: Coronary microvascular dysfunction was common among patients with type 2 diabetes mellitus and was significantly associated with cognitive decline, elevated stroke risk, and adverse metabolic profiles. Early identification of microvascular dysfunction may improve vascular risk stratification and guide preventive strategies in diabetic patients.

Prevalence of Diabetes Mellitus and Hypertension in Adult Population of Rural Pakistan: A Cross-Sectional Study

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Date: 20/05/2026
Abstract: Background: Diabetes mellitus (DM) and hypertension (HTN) are significant non-communicable conditions with overlapping risk factors and high morbidity and mortality. Their prevalence in adults, in order to plan their prevention, requires understanding. Objective: To find out the prevalence of diabetes mellitus and hypertension in adults population. Methods: The study was a cross sectional study carried out between Jan, 2024 and December, 2024 with 422 adults who received outpatient and community care. Consecutive sampling was used to select the participants. The socio-demographic information was gathered using structured questionnaires. Blood pressure was recorded with the help of standardized sphygmomanometer and diabetes was evaluated with the help of random blood glucose and history recorded. Data was analyzed in SPSS v24, and the descriptive statistics, chi-square and p-values less than 0.05 were taken into account as significant. Results: The average age of respondents was 44.6 ± 13.8 years and 53.6% of them were females. The diabetes mellitus prevalence was 29.9%, hypertension 37.4%, and 21.8% had both. The disease prevalence of both diseases rose considerably with age (p < 0.001). Urban residents were more likely to have diabetes (p = 0.018), whereas men had higher chances of having hypertension (p = 0.041). Conclusion: Diabetes mellitus and hypertension are very common in adults and mostly in the older age and urbania. The widespread cooccurrence highlights the fact that screening at an earlier age, combined management, and health programs of the population would be necessary to decrease morbidity and complications