CONTROL OF BLOOD PRESSURE IN HYPERTENSIVE PATIENTS WITH DIABETES MELLITUS TYPE 2

Abstract

Objective: To determine the frequency of hypertension and proportion of patients
achieving good control of blood pressure (BP) and to examine the relationship of
BP control with different variables in type 2 diabetes.
Methodology: This prospective observational study was conducted at
Department of Medicine, 1 Mountain Medical Battalion (Bagh, Azad Kashmir)
from April to December 2013. This study was done on diabetic patients. History
of previously diagnosed hypertension/ use of any antihypertensive medicines
was obtained. BP was measured twice in an upright position and the mean
calculated; values <140/90 mmHg reflected good control. Data analysis was
carried out with STATA version 12.
Results: Out of 178 patients, 72 (40.45%) had hypertension which was more
common in females than males (48.51% vs. 29.87%; p=0.012). A single
antihypertensive was used in 37 and two drugs in 35 patients but BP was at goal
in only 33 (45.83%) patients. Plasma glucose fasting was ≤7.0mmol/l in 46
(25.84%) patients. HbA1cwas <7% in 14 (20.29%) out of 69 patients. Amongst
the two groups with good and poor control of BP, there was no difference in
proportions of elderly (p=0.705), males (p=0.212), more educated patients
(p=0.316) or smokers (p=0.868).Proportions of patients with diabetes or
hypertension of more than 5 years duration were also similar as were fractions of
patients with increased BMI (p=0.339)or waist circumference
(p=0.077),elevated fasting plasma glucose (p=0.488) or HbA1c (p=0.509).
Conclusion: Hypertension is frequently encountered in diabetics. A more
aggressive treatment approach is required to achieve a better control of blood
pressure.