Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

A Brave Battle Against Hypertension In Patients With Type 2 Diabetes Mellitus

(2018) Bouwer, A. (Anna)

Background: The combination of type 2 diabetes mellitus (T2DM) and hypertension is
unfavourable due to the strongly increased cardiovascular risk. Hypertension is hard to treat in
patients with T2DM and often a large number of antihypertensive drugs is required. Patients
often fail to reach their blood pressure (BP) targets, with several potential causes.
Objective: We examine BP target achievement in patients with T2DM during two-years
follow-up. Also, we investigate whether antihypertensive drug therapy (AHT) was altered
during follow-up and whether this was associated with BP target achievement.
Methods: This study contains a prospective cohort study in 368 patients with T2DM, treated
in secondary health care. At baseline, BP was measured and blood and urine samples were
collected. Follow-up data was acquired from electronic patient files and pharmacy data.
Results: BP target achievement increased from 34 percent of the patients at baseline to 41
percent at two-year follow-up. Regardless of the baseline status, two-third of the patients
remained “on target” or “not on target” and one-third changed their status after two-year
follow-up. In half of the patients with baseline BP not on target (BP-NOT) an intensification
of AHT was made during follow-up, which led to a BP on target (BP-OT) in only a quarter of
these patients.
Conclusion: BP control in patients with T2DM remains a difficult task, as still less than half
of the patients achieved the BP target at two-year follow-up. As only a quarter of the patients
with baseline BP-NOT in whom AHT was intensified reached a two-year BP-OT, nonpharmaceutical
options should be considered as an important option to treat hypertension in
patients with T2DM.

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