Background The control of blood pressure is one of the main objectives in type 2 diabetes mellitus (T2D) management, as well as glycaemic control.
Purpose The first objective of this study was to describe the practise in hypertensive drug management in a cohort of DT2 patients from a diabetology department of a university hospital and to compare this practise with the current guidelines for hypertension treatment (HGs).
Materials and Methods This retrospective study examined T2D outpatients who came to the diabetology department between June and November 2010 for an annual cheque-up. Clinical and therapeutic data were extracted. Patients’ blood pressure levels were measured by an automated procedure (Dynamap).
Results The analysis was carried out on 803 patients (age: 64.9 ± 8.9 yrs; 38.6% women). The combination of T2D with confirmed hypertension was frequent (82.9%) and higher than the national results (80%). This situation was associated with cardiovascular and renal complications for 21% and 22.4% of the patients, respectively. The average systolic and diastolic blood pressures were 132.9 and 71.3 mmHg, respectively. Recommended objective for DT2 patients (<130/80 mmHg) was reached for 44.6% of the patients. Mono, dual and triple therapies were in accordance with the HGs in 100%, 95% and 85% of the patients, respectively. The effect of these different combinations, illustrated by the median of the blood pressure levels, was better for monotherapies (128.5/70.3 mmHg) than for dual and triple therapies (132.5/72 and 131/70.8 mmHg, respectively). 19% of patients had to take at least 4 anti-hypertensive drugs and the median of their systolic and diastolic blood pressures were 135.5 and 71 mmHg, respectively.
Conclusions In DT2 patients, blood pressure control should be improved, with for example earlier detection of hypertension and/or therapeutic reinforcement. However, antihypertensive drug management seems to be in accordance with the French official guidelines. The development of new drugs and patient education programmes may improve patient adherence.
No conflict of interest.
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