Research carried out by Dundee University suggests smoking and diabetes can lead to a drastically increased chance of limb amputation.
Work part funded by the British Heart Foundation (BHF) uncovered a link between smoking and diabetes and peripheral artery disease (PAD), a thinning of the arteries.
The university’s work suggests diabetics who smoke are 16 times more likely to develop PAD than non-smoking non-diabetics.
Cholesterol came top of the list of risk factors for coronary heart disease (CHD), when the coronary arteries supplying the heart become narrowed and can cause a heart attack.
The research followed 15,737 initially healthy people for 20 years in the Scottish Heart Health Extended Cohort (SHHEC). Over that time, 20% developed CHD, while three per cent developed PAD.
Both PAD and CHD are caused by fatty, inflamed, fibrous “plaques” called atheroma, developing within the walls of arteries, narrowing them and obstructing blood flow.
In PAD, this process can lead to limb amputation and, in CHD, narrowing of the coronary arteries can result in a heart attack.
The researchers say that this difference in risk factors may point to a new way to treat people suffering from PAD.
Professor Hugh Tunstall-Pedoe, emeritus professor and SHHEC study director at Dundee University, said: “Years ago blood cholesterol was the notorious chief villain in the list of causes of atheroma.
“We have found it still true for the coronary arteries of the heart, but cholesterol is demoted by smoking, diabetes, and evidence of inflammation, in the arteries of the legs.”
