Resistant Hypertension in Type 2 Diabetes: Prevalence and Patient Characteristics

Abstract

Background and aimsResistant hypertension is defined as failure to achieve blood pressure lower than 140/90 mmHg when using three antihypertensive agents or controlled blood pressure with four or more drugs. We aimed at assessing the prevalence of resistant hypertension and to describe a type 2 diabetes population with resistant hypertension.MethodsThe retrospective observational study included (n=73) type 2 diabetes subjects with resistant hypertension selected from (n=728) subjects admitted to the Centre of Diabetes, Cluj, Romania.ResultsThe subjects (70% women) had a mean age of 65.0±8.9 yrs. and diabetes duration 11(6–19) yrs. Prevalence of resistant hypertension was 10%. Chronic diabetes complications and cardiovascular disease were present in 77% and 56% of subjects respectively. On admission, antihypertensive drugs used were: angiotensin-converting enzyme inhibitors or angiotensin II receptors blockers 93%, β-blockers 88%, diuretics 78%, calcium channels blockers 59%, adrenergic α-antagonists 11%. Systolic and diastolic blood pressure were lower in the last compared to first admission day. Diuretics and calcium channels blockers were the most frequently newly added antihypertensive agents.ConclusionAlthough the prevalence of resistant hypertension in type 2 diabetes did not differ from the general population, we observed that these patients had increased frequency of chronic diabetic complications. Angiotensin-converting enzyme inhibitors or angiotensin II receptors and β-blockers were the most used antihypertensive drugs, while the most frequently newly prescribed drugs were diuretics and calcium channel blockers.

The Prevalence of Resistant Hypertension Among Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology, and Genetics

“…Prevalence of RH among diabetic patients was reported by a few studies; RIACE study reported that RH among type 2 diabetic patients was 17% in Spain [16]. Also 10% was the prevalence of RH among Italian type 2 diabetes patients [17]. The result of this study was consistent with other studies conducted among diabetic patients.…”

“…Previous epidemiologic studies indicated that the prevalence of RH among hypertensive population ranges from 10% to 30% [10]. Many studies reported that diabetes was a significant risk factor of RH occurrence among hypertensive patients [10,[12][13][14][15][16][17][18][19][20][21]. In comparing the results of this study with others which were conducted among hypertensive patients without type 2 diabetes, the prevalence of RH was higher.…”

“…RH was detected in 2,363, accounting for 15% of the population sample and 17.4% of hypertensive diabetic patients [16]. Also in a retrospective observational study conducted in Italy, it was 10% [17]. Another analysis study was conducted to evaluate clinical differences between RH patients and patients controlled on three or less drugs, and they found that those with RH had a higher prevalence of diabetes mellitus of 18.8% versus 3.5% among patients treated and controlled with three or less [18].…”

Suboptimal Blood Pressure Control, Associated Factors, and Choice of Antihypertensive Drugs among Type 2 Diabetic Patients at KCMC, Tanzania

“…This is because it was a community-based study; i.e., there is a difference in the study population. The lowest findings were in the Netherlands with prevalence of 15% [15] and in the study done in Romania with prevalence of 10% [16]; this is because of the different methodology used in our study, they used cohort, and the retrospective nature of the study, respectively.…”

Resistant Hypertension in Patients With Type-2 Diabetes Mellitus: A Single-Center, Cross-Sectional Study

“…The prevalence of resistant hypertension with type 2 diabetes mellitus (T2DM) varies in different countries. A study published in 2015 estimated that the prevalence of resistant hypertension was 10% in Romania [5]. Moreover, according to the National Health and Nutrition Examination Survey (NHANES), the prevalence of resistant hypertension was 8.9% in the United States between 2003 and 2008, and has increased to 13% in…”