Uncontrolled hypertension in patients with type 2 diabetes: What are the correlates?. Issue 9 (21st August 2021)

• Record Type: Journal Article
• Authors: Rabizadeh, Soghra; Gholami, Bahareh; Mahmoudzadeh Kani, Shiva; Rajab, Armin; Farrokhpour, Hossein; Esteghamati, Alireza; Nakhjavani, Manouchehr
• Is Part Of: Journal of clinical hypertension. Volume 23:Issue 9(2021)
• Page Start: 1776
• Page End: 1785
• Publication Date: 2021-08-21
• Subjects: BMI -- hypertension -- metabolic syndrome -- non‐HDL cholesterol -- pulse pressure -- type 2 diabetes mellitus; Hypertension -- Periodicals; 616.132
• DOI: 10.1111/jch.14352
• Languages: English
• ISSNs: 1524-6175

Abstract

Abstract: Suboptimal blood pressure (BP) control in patients with type 2 diabetes is associated with adverse micro‐ and macrovascular complications. This study aimed to investigate the predictors of uncontrolled hypertension in an Iranian population with type 2 diabetes. This is a cross‐sectional study of 2612 patients with type 2 diabetes, including 944 patients with hypertension. Controlled and uncontrolled hypertension were assessed. Multivariate logistic regression modeling was used to determined independent predictors of uncontrolled hypertension. Of 2612 patients with type 2 diabetes, 944 (36.1%) patients had hypertension. Of all patients with hypertension, 580 (61.4%) were still on monotherapy. Uncontrolled hypertension was detected in 536 participants (56.8%). Patients with uncontrolled hypertension had significantly higher body mass index (BMI) (29.8±4.8 vs. 28.6±4.6), waist circumference (99.11±10.95 vs. 96.68±10.92), pulse pressure (67.3±17.3 vs. 48.4±10.7), total cholesterol (177.1±45.5 vs. 164.3±40.5), non‐HDL cholesterol (133.0±43.5 vs. 120.1±38.7), triglycerides (175.7±80.3 vs. 157.4±76.7), and Atherogenic Index of Plasma (AIP) (0.57±0.23 vs. 0.52±0.24) ( p < .05 for all of them ) compared to patients with controlled hypertension. Multivariate logistic regression analysis revealed that uncontrolled hypertension was significantly associated with BMI ( p = .001), pulse pressure ( p = .001), total cholesterol ( p = .006), and non‐HDL cholesterol ( p = .009). In patients with triglycerides levels > 200 mg/dl non‐HDL cholesterol had a significant correlation with uncontrolled hypertension (OR = 4.635, CI95%:1.781–12.064, p = .002). In conclusion, BMI, pulse pressure, total cholesterol, and non‐HDL cholesterol are significant predictors of uncontrolled hypertension in patients with type 2 diabetes. Also, ineffective monotherapy, medical inertia and patients' non‐compliance were other contributors to the uncontrolled hypertension.