Blood Pressure Control in an 11-Year Cohort of Diabetic and Non-Diabetic Individuals with Hypertension

Abstract

Aim: To analyze Blood Pressure (BP) control among hypertensive individuals with or without type 2 Diabetes Mellitus (DM) who were followed over 11 years at a reference center. Method:This was a historical cohort study of patients who were regularly treated for hypertension and who had DM as an exposure factor. Time-points of assessment: baseline -2004, mid-term -2009 and final -2015. Variables: gender, race, age, BP, Body Mass Index (BMI), and length of treatment at specialized service. The BP goals were <140/90 mmHg for non-diabetics with hypertension and <130/80 mmHg (stricter goal) or <140/90 mmHg (standard goal) for diabetics with hypertension. An association analysis was performed using the chi-square or Fisher's exact test, with a 5% significance level. Results:The sample included 139 individuals with hypertension (diabetic: 55; non-diabetic: 84). When stricter goals were considered, the participants with diabetes exhibited poorer BP control rates at all the time-points of assessment (23.6%, 27.3%, and 29.1%) compared to the non-diabetic patients (57.1%, 67.9%, and 69.0%)(p<0.001). When the standard goals were applied to both groups (<140/90), no differences in control rates between the groups were observed (p>0.05). Specifically, the BP control rates in the group of patients with DM at the three time-points were 47.3%, 61.8%, and 60.0%. In the case of SPB, there was no difference in mean values (continuous variable) when compared between diabetic and non -diabetic hypertensives (p>0.05), in all evaluations. And, in the case of DBP, the values have been reduced over time in both groups of patients. Conclusion:The presence of DM was associated with poorer BP control rates when stricter goals were considered; this difference disappeared when similar goals were applied to both groups.

Hypertensive diabetic patients: incidence of cardiovascular and renal outcomes in a historical cohort over 11 years

“…On the other hand, they showed worse BP control rates. It should be noted that stricter parameters were considered for BP control among diabetics [ 20 ]. T2DM patient care should be the result of integral management of cardiovascular risk, which includes other factors than glucose, such as dyslipidemias, obesity and hypertension [ 3 ].…”