A. Papazafiropoulou, A. Sotiropoulos, A. Kokolaki, S. Bousboulas, M. Kardara, S. Pappas
It is well documented that hypertension is more prevalent among type 2 diabetic (T2D) subjects. Successful tight blood pressure control allows to significantly reducing the incidence of microvascular and cardiovascular complications in T2D subjects; unfortunately, adequate blood pressure control is reportedly not achieved in up to 50–75% of diabetic patients. Therefore, we performed a retrospective analysis in order to estimate the prevalence of resistant hypertension among Greek T2D subjects. We performed a retrospective analysis of the medical records of 664 T2D subjects (mean age ± standard deviation: 65.5 ± 9.8 years, 341 females / 323 males) with arterial hypertension attending the diabetes outpatient clinic of our hospital during the period from 1 January 2010 to 30 September 2010. Of the study participants, 20.8% (n=138) had resistant hypertension. The antihypertensive treatment of the diabetic subjects with and without resistant hypertension was, respectively; 59.4% vs. 47.9% on angiotensin-converting enzyme inhibitors (ACE-I) (P=0.01), 45.7% vs. 21.9% on angiotensin II receptor blockers (ARBs) (P<0.001), 52.2% vs. 23.0% on β-blockers (P<0.001), 12.3% vs. 1.5% on centrally acting antihypertensives (P<0.001), and 71.0% vs. 29.7% on calcium channel blockers (P<0.001). Of the diabetic subjects without resistant hypertension 39.53% was on treatment with diuretics. Multivariate logistic analysis adjustment resistant hypertension was associated with body mass index (BMI) (OR: 1.06, 95% CI: 1.02-1.11, P<0.001), presence of coronary artery disease (OR: 1.83, 95% CI: 1.21-2.77, P=0.004), and insulin therapy (OR: 1.78, 95% CI: 1.15-2.75, P=0.01). In conclusion, the present study showed that a significant percentage of T2D subjects have resistant hypertension that is related with body mass index, presence of coronary artery disease and insulin treatment.
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