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Possible correlation between glycemia and blood pressure in black, diabetic, hypertensive patients
L A Jaber1, W R Melchior, D R Rutledge
1College of Pharmacy and Allied Health Profession, Wayne State University, Detroit, MI 48202.
Insights
This study found a strong positive association between blood glucose levels and blood pressure in Black patients with hypertension and diabetes. Better glucose control correlated with improved blood pressure, highlighting the link between glycemia and hypertension management.
Area of Science:
- Internal Medicine
- Cardiology
- Endocrinology
Background:
- Hypertension and diabetes mellitus are prevalent chronic conditions, particularly in Black populations.
- Managing both conditions concurrently presents significant challenges in patient care.
- The interplay between glycemic control and blood pressure is crucial for cardiovascular health.
Purpose of the Study:
- To investigate the association between glycemia and blood pressure.
- To examine this relationship in Black patients with hypertension and type II diabetes.
- To assess the impact of stable antihypertensive medication regimens on this association.
Main Methods:
- Retrospective study design analyzing data from March 1990 to February 1991.
- Inclusion criteria: Black patients with hypertension and type II diabetes, stable antihypertensive medications for six months, no secondary hypertension, and minimal weight change.
- Measurements included systolic and diastolic blood pressure (SBP and DBP) and postprandial capillary blood glucose (PCBG) at baseline and six months.
Main Results:
- A significant positive association was observed between blood pressure and glycemia.
- Overall SBP changes strongly correlated with PCBG changes (r = 0.745, p < 0.0001).
- Improved glycemic control was linked to better SBP control (r = 0.330, p < 0.0024), while worsening glycemia correlated with poorer SBP control (r = 0.445, p < 0.0053).
Conclusions:
- Glycemic control is positively associated with blood pressure levels in this patient cohort.
- Maintaining stable antihypertensive medication did not alter the observed association.
- Findings underscore the importance of integrated management of diabetes and hypertension.
Objective:
To determine if there is any association between glycemia and blood pressure in black patients with hypertension and diabetes mellitus whose antihypertensive medications had been unchanged for six months.
Design:
Retrospective, from March 1990 through February 1991.
Setting:
Internal medicine ambulatory clinic at Detroit Receiving Hospital/University Health Center.
Patients:
Patients seen during this period with hypertension and type II diabetes. Of the 639 possible subjects, 124 met the following criteria: (1) no change in antihypertensive medications for six months, (2) absence of secondary hypertension, and (3) weight change (if any) was less than five percent. Changes in antihypertensive medication(s) excluded 388 patients, secondary hypertension excluded 3, weight changes of more than five percent excluded 94, and lack of matching postprandial capillary blood glucose (PCBG) values excluded 30. The mean age of the subjects was 66.8 years, mean diabetes duration was 12.0 years, mean PCBG was 10.7 mmol, mean systolic blood pressure (SBP) was 1543 mm Hg, mean diastolic blood pressure (DBP) was 90.1 mm Hg. There were 28 men in the study and 96 women; 90 were obese (body mass index greater than 25 kg/m2) and 34 were nonobese. The diabetes was managed with insulin in 67 patients, with sulfonylureas in 50, and with diet in 7.
Intervention:
None
Main Outcome Measures:
SBP and DBP versus PCBG at matching time both at baseline and at six months.
Results:
There was a positive association between blood pressure measurements and glycemia. Overall change in SBP was strongly correlated with PCBG changes (r = 0.745, p less than 0.0001). Improved glycemia correlated with improved SBP control (r = 0.330, p less than 0.0024). Deterioration of glycemia correlated with a worsening of SBP control (r = 0.445, p less than 0.0053). The method of blood glucose control had no statistically significant effect (ANOVA) on these results.
Conclusions:
Glycemia is positively associated with blood pressure.