Blood pressure control in subjects with type 2 diabetes

Area of Science:

• Endocrinology
• Nephrology
• Cardiology

Background:

• Type 2 diabetes significantly increases cardiovascular and renal risks.
• Effective blood pressure (BP) management is crucial for preventing complications in diabetic patients.
• Primary care settings often face challenges in achieving optimal BP control in this population.

Purpose of the Study:

• To assess blood pressure control in type 2 diabetic patients under 65 years in primary care.
• To evaluate the utility of 24-hour ambulatory BP measurement (ABPM) for hypertension management in diabetic individuals with elevated diastolic BP.
• To investigate the association between BP control, albuminuria, and hypertension diagnosis in type 2 diabetes.

Main Methods:

• A two-phase study involving 260 type 2 diabetic subjects for BP assessment and 48 subjects with elevated diastolic BP for ABPM.
• Casual BP measurements and 24-hour ambulatory BP monitoring were utilized.
• Urinary albumin excretion rate was measured to assess for albuminuria.

Main Results:

• Mean BP in participants was 156/91 mm Hg, with 58% meeting hypertension criteria.
• Hypertension diagnosis was delayed, as 38% of those without a diagnosis had elevated BP.
• Poor BP control was significantly associated with albuminuria (42% vs 27%, P = 0.018).

Conclusions:

• Blood pressure control is unsatisfactory and hypertension diagnosis is frequently delayed in type 2 diabetes patients.
• Microalbuminuria is linked to poor BP control, suggesting its value in monitoring BP management.
• Further studies are required to establish the role of 24-hour ABPM in managing hypertension in type 2 diabetes.