Trends in Hypertension Prevalence, Awareness, Treatment and Control in an Adult Type 2 Diabetes Spanish Population between 2003 and 2009

Abstract

In patients with type 2 diabetes, the prevalence of hypertension is higher than in non-diabetic subjects. Despite the high cardiovascular risk involving hypertension in these patients, its prevalence and control are not well known. The aims of this study were: to estimate the hypertension prevalence, awareness, treatment and control in Spanish adults with type 2 diabetes attended in Primary Care; and to analyse its time trend from 2003 to 2009. A serial cross-sectional study from 2003 to 2009 was performed in 21 Primary Care Centres in Madrid. The study population comprised all patients with diagnosed type 2 diabetes in their computerised medical history. Overall annual prevalence during the period 2003–2009 was calculated from and according to sex and age groups. Linear trend tests, regression lines and coefficients of determination were used. In 2003 89.78% (CI 87.92–91.64) of patients with type 2 diabetes suffered hypertension and 94.76% (CI: 92.85–96.67) in 2009. This percentage was greater for women and for patients over 65 years old. 30% of patients suffered previously undiagnosed hypertension in 2003 and 23.1% in 2009. 97% of diagnosed patients received pharmacological treatment and 28.79% reached the blood pressure objective in 2009. The average number of antihypertensive drugs taken was 2.72 in 2003 and 3.27 in 2009. Only 5.2% of patients with type 2 diabetes show blood pressure levels below 130/80 mmHg. Although significant improvements have been achieved in the diagnosis and control of hypertension in people with type 2 diabetes, these continue to remain far from optimum.

Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study

“…It is also possible that some patients in our cohort not on antihypertensive medication at baseline could have represented untreated hypertensive patients, which may have limited the responsiveness to IVB due to continued hypertension. Indeed, up to 30% of diabetics can have undiagnosed/untreated hypertension 23,24. However, treating hypertension has not been found to reduce the progression to clinically significant DME in patients with established retinopathy 21…”

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

“…In a Spanish cohort, the incidence of T2DM and hypertension increased from 89.8% in 2003 to 92.9% in 2009, and the percentages were higher for women or individuals >65 years of age. 66 Interestingly, in a Swedish study of individuals who were all 50 years of age, men had a greater prevalence of hypertension or metabolic syndrome that included T2DM than did women, but in women, the prevalence of hypertension with metabolic syndrome was greater. 69 Therefore, within various ethnic cohorts, DM and hypertension are strongly linked, and this is especially true in postmenopausal women.…”

“…65 However, with menopause, more women exhibit hypertension than do men of comparable age. 65 Hypertension is a common occurrence in individuals who have both T2DM and type 1 DM (T1DM), 66 and there are sex differences in the development of hypertension with T2DM that seem to be age related. In the Western New York Health Study, the strongest indicators for development of hypertension were impaired fasting glucose and weight gain after 25 years of age.…”

Blood pressure levels and control in Italy: comprehensive analysis of clinical data from 2000–2005 and 2005–2011 hypertension surveys

“…8 Among these interventions, the availability of updated and comprehensive epidemiological data on hypertension prevalence and control represents a key point for the understanding the size of the problem, as well as to address and evaluate the proper strategies to reduce this gap in our Country. Compared with other international experiences, 9,10 systematic, comprehensive and periodical analyses on hypertension prevalence and control in Italy have been undertaken only in the recent years, although limited on local initiatives. For example, analyses of large clinical databases on physicians' attitudes and preferences for prescribing antihypertensive medications and patients' adherence to the prescribed antihypertensive therapy have been very recently assessed in Regione Lombardia, 11,12 demonstrating high incidence of drug discontinuations and low proportions of attained BP control.…”