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Uncontrolled Hypertension in Patients With Type 2 Diabetes: What Are the Correlates? Publisher Pubmed



Rabizadeh S1 ; Gholami B1 ; Mahmoudzadeh Kani S1 ; Rajab A1 ; Farrokhpour H1 ; Esteghamati A1 ; Nakhjavani M1
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Authors Affiliations
  1. 1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Clinical Hypertension Published:2021


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. © 2021 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC
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