[Arterial hypertension management in patients with type 2 diabetes]

To assess hypertension management and blood pressure control in patients with type 2 diabetes in France.

A cross sectional study was conducted in a representative sample of 410 diabetologists. The first 8 patients with type 2 diabetes, treated with oral antidiabetic agents and/or insulin, received at practitioner's office were included. Cardiovascular risk factors, antihypertensive drugs, cardiovascular history were reported. BP was measured. Patients considered as hypertensive by his practitioner and receiving antihypertensive drugs were considered as hypertensives. Controlled hypertension was defined as a blood pressure < 140/80 mmHg. Uncontrolled hypertension was defined as blood pressure > or = 140/80 mmHg.

4,930 diabetics were included in the study. Of them 3,085 (63%) patients were hypertensives. They were markedly older, overweight and reported most frequently complications. Only 723 (23%) patients presented with controlled hypertension. 40% of hypertensives were under monotherapy, 36% received 2 antihypertensive treatments and 24% received 3 treatments or more. ACE-inhibitors (49%), diuretics (41%), beta-blockers (35%), calcium channel blockers (33%), angiotensin II antagonists (19%) were the most commonly prescribed agents. Apart from hypertension, the main risk factors associated with each kind of prescription was micro or macroalbuminuria for ACE-I (OR = 1.5), coronary artery disease for beta-blockers and calcium channel blockers (OR = 3.8 and 2.5 respectively), and age for diuretics and angiotensin II antagonists (OR = 1.05 and 1.03).

This study conducted in a representative sample of french diabetologists indicated that despite the large use of antihypertensive treatments only 23% of hypertensive diabetics were well controlled. Due to the high CV risk of these patients, hypertension management is of major importance.