Assessment and management of hypertension in patients with type 2 diabetes

Thomas, Merlin C.; Atkins, Robert C.

doi:10.1111/j.1445-5994.2008.01696.x

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…As per previous research, the frequency of hypertension was high among the patients and higher among those who had an uncontrolled HbA 1c level 26,30,31. The prevalence of retinopathy and heart diseases as comorbidities among our DM patients was less than the previous local study 32.…”

Section: Discussionsupporting

confidence: 65%

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study

Abdulghani¹,

Alrajeh²,

Alsalman³

et al. 2018

DMSO

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BackgroundDiabetes mellitus with comorbid complications constitute a major public health problem worldwide. The aim of this study was to evaluate the risk of comorbid complications with glycosylated hemoglobin levels and diabetes duration. Also assessed were patients’ diabetic foot-care knowledge and practices.Patients and methodsThis was a quasiexperimental study. A total of 360 type 2 diabetes mellitus patients were interviewed at a government health care center in Riyadh, Saudi Arabia. Diabetic complications and HbA1c-level data were collected from hospital records. A standard questionnaire was used to assess their diabetic foot-care knowledge and practice.ResultsOf the type 2 diabetes mellitus patients, 32.5% had highly uncontrolled glycosylated hemoglobin (HbA1c) levels (≥8.6%) and 62.8% had had diabetes >10 years. The patients had comorbid complications, such as hypertension (61.4%), dyslipidemia (58.6%), retinopathy (23.3%), heart disease (14.4%), and severe foot complications (3.9%). The majority of highly uncontrolled HbA1c-level patients had retinopathy (OR 8.90, P=0.0001), foot complications (OR 8.09, P=0.0001), dyslipidemia (OR 2.81, P=0.010), and hypertension (OR 2.0, P=0.028) compared to the controlled HbA1c-level (<7%) group. Patients with diabetes >10 years also had higher prevalence of foot complications (OR 2.92, P=0.0001), retinopathy (OR 2.17, P=0.011), and hypertension (OR 1.67, P=0.033). From patient responses, physicians examined only 34.2% of patient feet and 36.7% of patients received physicians advice for foot care. About 70% of patients had knowledge of diabetic foot care; however, only 41.7% of patients always examined their feet, 41.4% washed feet with warm water, 31.4% carefully dried between the toes, and 33.1% were using foot-moisturizing substances.ConclusionThe prevalence of comorbid complications was higher in the Saudi population compared to other international studies. Also, foot-care practice was not satisfactory. Therefore, there is need of improvement and increased awareness among physicians and patients to check regularly for proper care of the diabetic foot to avoid diabetic foot-related complications.

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Section: Discussionsupporting

confidence: 65%

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study

Abdulghani¹,

Alrajeh²,

Alsalman³

et al. 2018

DMSO

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“…Interestingly, this association was similar in patients with higher and lower SBP during follow-up and was directly comparable to the 18% reduction in the risk for cardiovascular disease for every halving of albuminuria rates reported from the Reduction in Endpoints in Noninsulin dependent diabetes mellitus with the Angiotensin II Antagonist Losartan (RENAAL) study. 35 In that study, discordant responses between albuminuria and BP were observed in a significant proportion of individuals, adding more support for albuminuria as a therapeutic target in addition to BP in patients with type 2 diabetes; however, both the analyses from RENAAL and this study are observational and should therefore be regarded as primarily exploratory.…”

Section: Subgroups Of Follow-up Egfr Levelsmentioning

confidence: 74%

Albuminuria and Kidney Function Independently Predict Cardiovascular and Renal Outcomes in Diabetes

Ninomiya

Perkovic

Galan

et al. 2009

Journal of the American Society of Nephrology

836

603

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There are limited data regarding whether albuminuria and reduced estimated GFR (eGFR) are separate and independent risk factors for cardiovascular and renal events among individuals with type 2 diabetes. The Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) study examined the effects of routine BP lowering on adverse outcomes in type 2 diabetes. We investigated the effects of urinary albumin-to-creatinine ratio (UACR) and eGFR on the risk for cardiovascular and renal events in 10,640 patients with available data. During an average 4.3-yr follow-up, 938 (8.8%) patients experienced a cardiovascular event and 107 (1.0%) experienced a renal event. The multivariable-adjusted hazard ratio for cardiovascular events was 2.48 (95% confidence interval 1.74 to 3.52) for every 10-fold increase in baseline UACR and 2.20 (95% confidence interval 1.09 to 4.43) for every halving of baseline eGFR, after adjustment for regression dilution. There was no evidence of interaction between the effects of higher UACR and lower eGFR. Patients with both UACR Ͼ300 mg/g and eGFR Ͻ60 ml/min per 1.73 m 2 at baseline had a 3.2-fold higher risk for cardiovascular events and a 22.2-fold higher risk for renal events, compared with patients with neither of these risk factors. In conclusion, high albuminuria and low eGFR are independent risk factors for cardiovascular and renal events among patients with type 2 diabetes.

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“… Notes: a Data of interest = incidence or prevalence of hypertension and/or obesity among adults with T2DM (searches one and two) or risk association of hypertension/obesity with long-term micro- or macrovascular complications of T2DM (search one only); b does not exclude patients hospitalized with T2DM complications; c publication types excluded were commentaries, case studies, interim reports when end-of-study data were available, and reviews for which primary data were already included; d one article (Thomas and Atkins29) reported on two studies, for a total of 78 studies in 77 articles.…”

Section: Figurementioning

confidence: 99%

“…Mid-range values are not shown in the figure. a Mean ages in the study by Hassing et al59 were 83.1–84.0 years; b Suh et al76 provided both low and high estimates; c Thomas and Atkins29 provided both low and high estimates (two studies in one report); d the low estimate in South America used an atypical definition of hypertension (the proportion of patients with systolic blood pressure >144 mmHg) 82…”

Section: Figurementioning

confidence: 99%

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Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review

Colosia¹,

Palencia²,

Khan³

2013

DMSO

317

208

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BackgroundHypertension and obesity are known to contribute, directly or indirectly, to the development of long-term complications of type 2 diabetes mellitus (T2DM). Knowing the prevalence of these comorbidities is important for determining the size of the population that may benefit from strategies that reduce blood pressure and weight while controlling blood glucose.MethodsIn this systematic literature review, electronic searches of PubMed, Embase, and the Cochrane Library were conducted to identify observational studies of hypertension and/or obesity prevalence in patients with T2DM throughout the world. The searches were limited to studies reported in English from January 1, 2001 to February 16, 2012.ResultsFrom a total of 2,688 studies, 92 observational studies provided prevalence rates for hypertension and/or obesity specifically in adults with T2DM. Fifteen studies of specific subtypes of hypertension or subpopulations with T2DM were subsequently excluded, leaving 78 studies (in 77 articles) for inclusion in this article. Of these, 61studies reported hypertension prevalence, 44 reported obesity prevalence, and 12 reported the prevalence of hypertension with obesity. Most studies had a low risk of bias regarding diagnosis of T2DM (70/78), hypertension (59/69), or obesity (45/47). The continental regions with the most observational studies of hypertension or obesity prevalence were Europe (n = 30) and Asia (n = 26). Hypertension rates typically were high in all regions; most studies presented rates above 50%, and many presented rates above 75%. Obesity rates exceeded 30% in 38 of 44 studies and 50% in 14 of 44 studies, especially those assessing central obesity (based on waist circumference). Among obese adults, hypertension rates were at or above 70% in Asia and above 80% in Europe; rates were lower in North and South America but still above 30%.ConclusionAround the world, hypertension and obesity, separately or together, are common comorbidities in adults with T2DM.

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Assessment and management of hypertension in patients with type 2 diabetes

Cited by 9 publications

References 11 publications

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study

Albuminuria and Kidney Function Independently Predict Cardiovascular and Renal Outcomes in Diabetes

Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review

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