Introduction: High blood pressure (BP) is a major cause of cardiovascular and renal related morbidity and mortality in people with diabetes. The American Diabetes Association recently relaxed its recommended target BP for diabetics to ≤140/80 mmHg. The aim of this study was to assess the prevalence and predictors of failure to achieve the above BP target.
Methods: This observational study examined patients attending the diabetes clinics at a tertiary referral hospital in Melbourne. BP was calculated as the average of the last two BP measurements recorded in our clinic database. All the characteristics used have been entered in our clinic database. Patients were divided into four groups on the basis of their BP levels and the number of BP lowering medications they were taking. Group 1- RES HTN (hypertension): resistant HTN (BP ≥140/80 mm Hg on 3 or more antihypertensives), Group 2- UC HTN: uncontrolled HTN (≥140/80 mmHg with < 3 antihypertensives, Group 3-CT HTN: controlled HTN (< 140/80 mmHg and taking antihypertensive) and Group 4-No HTN: (< 140/80 and not on any medications)
Results: A total of 686 patients were eligible for this study. The prevalence and characteristics of patients in each of the four BP groups are shown in Table 1. The prevalence of patients with a BP ≥140/80 mmHg was 22.4 % (9.9% in Group 1-RES HTN and 12.5% in Group 2- UC HTN). Patients in group 1 tended to be older (p < 0.001), heavier (p <0.001), had higher ACRs (albumin-creatinine ratios) (p<0.001) and had lower eGFR (estimated glomerular filtration rates) (p<0.001) than patients in the other three BP groups.
Conclusions: Our study identified that the prevalence of resistant HTN is lower than quoted in other multicentre hypertension studies, with rates in the general population reported to range between 25% to 30 % (1,2). As resistant HTN is associated with poor prognosis, new strategies need to be developed to help patients lower their blood pressure (3).