Blood pressure targets for hypertension in patients with type 2 diabetes

Aronow, Wilbert S.; Shamliyan, Tatyana

doi:10.21037/atm.2018.04.36

Cited by 10 publications

(14 citation statements)

References 205 publications

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“…The current clinical parameter for diagnosing hypertension is systolic blood pressure values of 130 mmHg or more and/or diastolic blood pressure above 80 mmHg [ 181 ]. In order to reduce the risk of stroke, it has been recommended that the blood pressure of DM patients be maintained between 120 and 130/80 mmHg [ 182 ].…”

Section: Main Findings and Discussionmentioning

confidence: 99%

Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Negrini

Carlos

Duque

et al. 2021

Front. Oral. Health

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This comprehensive review of the literature aimed to investigate the interplay between the oral microbiome, oral cavity conditions, and host immune response in Diabetes mellitus (DM). Moreover, this review also aimed to investigate how DM related risk factors, such as advanced age, hyperglycemia, hyperlipidemia, obesity, hypertension and polycystic ovary syndrome (PCOS), act in promoting or modifying specific mechanisms that could potentially perpetuate both altered systemic and oral conditions. We found that poorly controlled glycemic index may exert a negative effect on the immune system of affected individuals, leading to a deficient immune response or to an exacerbation of the inflammatory response exacerbating DM-related complications. Hyperglycemia induces alterations in the oral microbiome since poor glycemic control is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of individuals with DM. A bidirectional relationship between periodontal diseases and DM has been suggested: DM patients may have an exaggerated inflammatory response, poor repair and bone resorption that aggravates periodontal disease whereas the increased levels of systemic pro-inflammatory mediators found in individuals affected with periodontal disease exacerbates insulin resistance. SARS-CoV-2 infection may represent an aggravating factor for individuals with DM. Individuals with DM tend to have low salivary flow and a high prevalence of xerostomia, but the association between prevalence/experience of dental caries and DM is still unclear. DM has also been associated to the development of lesions in the oral mucosa, especially potentially malignant ones and those associated with fungal infections. Obesity plays an important role in the induction and progression of DM. Co-affected obese and DM individuals tend to present worse oral health conditions. A decrease in HDL and, an increase in triglycerides bloodstream levels seem to be associated with an increase on the load of periodontopathogens on oral cavity. Moreover, DM may increase the likelihood of halitosis. Prevalence of impaired taste perception and impaired smell recognition tend to be greater in DM patients. An important interplay among oral cavity microbiome, DM, obesity and hypertension has been proposed as the reduction of nitrate into nitrite, in addition to contribute to lowering of blood pressure, reduces oxidative stress and increases insulin secretion, being these effects desirable for the control of obesity and DM. Women with PCOS tend to present a distinct oral microbial composition and an elevated systemic response to selective members of this microbial community, but the association between oral microbiome, PCOS are DM is still unknown. The results of the studies presented in this review suggest the interplay among the oral microbiome, oral cavity conditions, host immune response and DM and some of the DM associated risk factors exist. DM individuals need to be encouraged and motivated for an adequate oral health care. In addition, these results show the importance of adopting multidisciplinary management of DM and of strengthening physicians-dentists relationship focusing on both systemic and on oral cavity conditions of DM patients.

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Section: Main Findings and Discussionmentioning

confidence: 99%

Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Negrini

Carlos

Duque

et al. 2021

Front. Oral. Health

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show abstract

“…interviewer administered questionnaire was used to collect data. Questionnaire was adapted from previous published articles [3, 7, 10, 11, 13, 22, 33–35], prepared in English and translated to Amharic and retranslated to English by another person (see Additional file 1). Four data collectors and two supervisors participated in data collection.…”

Section: Main Textmentioning

confidence: 99%

“…Decreasing of SBP by 10 mmHg lead to 12% reductions of diabetes complications [9, 10]. SBP increases after 50–60 years due to age-related changes in vasculature [11].…”

Section: Introductionmentioning

confidence: 99%

Predictors of isolated systolic hypertension among type 2 diabetes mellitus patients in Jimma University Specialized Hospital, Southwest Ethiopia

Dagnew

Yeshaw

2019

BMC Res Notes

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Objectives Systolic blood pressure rise among T2DM patients was main risk factor for cardiovascular disease. Objective of this study was to identify predictors of isolated systolic hypertension among T2DM patients at Jimma University Specialized Hospital, 2016. We conducted cross sectional study using simple random sampling and interviewer administered questionnaire. Isolated systolic hypertension is SBP ≥ 140 mmHg and < 90 mmHg. Data entered and analyzed using Epi Data and SPSS respectively. Predictor factor was declared at p < 0.05. Results A total of 315 T2DM took part. Prevalence of ISH was 27.6% [95% CI (22.7, 32.5%)]. One hundred sixty and two (51.4%) patients were males with mean age of 54.1 from 22 to 87 years. Male sex [AOR = 2.4, 95% CI 1.21–4.72, p = 0.012], unemployment [AOR = 3.22, 95% CI 1.48–7.03, p = 0.003], age of 47–55 [AOR = 2.63, 95% CI 1.03–6.70, p = 0.044], single [AOR = 2.26, 95% CI 1.13–4.51, p = 0.021], ≤ Grade 8 [AOR = 2.94, 95% CI 1.10–7.85, p = 0.03] and income (ETB) 501–800 [AOR = 21.9, 95% CI 7.62–63.1, p < 0.001], 801–1500 [AOR = 5.78, 95% CI 2.55–13.1, p < 0.001] and > 1500 [AOR = 4.23, 95% CI 1.74–10.30, p = 0.001] were significant factors of ISH. The health sector has to establish preventive strategies for ISH among T2DM patients by giving special attention to predictor factors. Electronic supplementary material The online version of this article (10.1186/s13104-019-4550-3) contains supplementary material, which is available to authorized users.

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“…A meta‐analysis of randomized controlled trials (RCTs) has shown a linear relationship between the reduction in HbA 1c and major cardiovascular events . Another meta‐analysis of RCTs, showed that reaching blood pressure targets was associated with decreased risk of diabetes‐related mortality . Additionally, very low LDL cholesterol level was associated with reduced cardiovascular risk in people with type 2 diabetes .…”

Section: Introductionmentioning

confidence: 99%

Variation in the achievement of HbA_1c, blood pressure and LDL cholesterol targets in type 2 diabetes in general practice and characteristics associated with risk factor control

et al. 2019

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To identify population, general practitioner, and practice characteristics associated with the achievement of HbA 1c , blood pressure and LDL cholesterol targets, and to describe variation in the achievement of risk factor control. Methods We conducted a cross-sectional survey of 9342 people with type 2 diabetes, 281 general practitioners and 77 general practices in Norway. Missing values (7.4%) were imputed using multiple imputation by chained equations. We used three-level logistic regression with the achievement of HbA 1c , blood pressure and LDL cholesterol targets as dependent variables, and factors related to population, general practitioners, and practices as independent variables. Results Treatment targets were achieved for HbA 1c in 64%, blood pressure in 50%, and LDL cholesterol in 52% of people with type 2 diabetes, and 17% met all three targets. There was substantial heterogeneity in target achievement among general practitioners and among practices; the estimated proportion of a GPs diabetes population at target was 55-73% (10-90 percentiles) for HbA 1c , 36-63% for blood pressure, and 47-57% for LDL cholesterol targets. The models explained 11%, 5% and 14%, respectively, of the total variation in the achievement of HbA 1c , blood pressure and LDL cholesterol targets. Use among general practitioners of a structured diabetes form was associated with 23% higher odds of achieving the HbA 1c target (odds ratio 1.23, 95% confidence interval (CI) 1.02-1.47) and 17% higher odds of achieving the LDL cholesterol target (odds ratio 1.17, 95% CI 1.01-1.35). Conclusions Clinical diabetes management is difficult, and few people meet all three risk factor control targets. The proportion of people reaching target varied among general practitioners and practices. Several population, general practitioner and practice characteristics only explained a small part of the total variation. The use of a structured diabetes form is recommended.

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Blood pressure targets for hypertension in patients with type 2 diabetes

Abstract: We concluded that in adults with diabetes mellitus and arterial hypertension, in order to reduce the risk of stroke, clinicians should target blood pressure at 120-130/80 mmHg, with close monitoring for all drug-related harms.

Cited by 10 publications

References 205 publications

Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Predictors of isolated systolic hypertension among type 2 diabetes mellitus patients in Jimma University Specialized Hospital, Southwest Ethiopia

Variation in the achievement of HbA_1c, blood pressure and LDL cholesterol targets in type 2 diabetes in general practice and characteristics associated with risk factor control

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Blood pressure targets for hypertension in patients with type 2 diabetes

Abstract: We concluded that in adults with diabetes mellitus and arterial hypertension, in order to reduce the risk of stroke, clinicians should target blood pressure at 120-130/80 mmHg, with close monitoring for all drug-related harms.

Cited by 10 publications

References 205 publications

Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

Predictors of isolated systolic hypertension among type 2 diabetes mellitus patients in Jimma University Specialized Hospital, Southwest Ethiopia

Variation in the achievement of HbA1c, blood pressure and LDL cholesterol targets in type 2 diabetes in general practice and characteristics associated with risk factor control

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Variation in the achievement of HbA_1c, blood pressure and LDL cholesterol targets in type 2 diabetes in general practice and characteristics associated with risk factor control