RESISTANT HYPERTENSION IN TYPE 2 DIABETES: PREVALENCE AND PATIENT CHARACTERISTICS

Background and aims. Resistant hypertension is defined as failure to achieve blood pressure lower than 140/90 mmHg when using three antihypertensive agents or controlled blood pressure with four or more drugs. We aimed at assessing the prevalence of resistant hypertension and to describe a type 2 diabetes population with resistant hypertension.Methods. The retrospective observational study included (n=73) type 2 diabetes subjects with resistant hypertension selected from (n=728) subjects admitted to the Centre of Diabetes, Cluj, Romania. Results. The subjects (70% women) had a mean age of 65.0±8.9 yrs. and diabetes duration 11(6-19) yrs. Prevalence of resistant hypertension was 10%. Chronic diabetes complications and cardiovascular disease were present in 77% and 56% of subjects respectively. On admission, antihypertensive drugs used were: angiotensin-converting enzyme inhibitors or angiotensin II receptors blockers 93%, β-blockers 88%, diuretics 78%, calcium channels blockers 59%, adrenergic α-antagonists 11%. Systolic and diastolic blood pressure were lower in the last compared to first admission day. Diuretics and calcium channels blockers were the most frequently newly added antihypertensive agents.Conclusion. Although the prevalence of resistant hypertension in type 2 diabetes did not differ from the general population, we observed that these patients had increased frequency of chronic diabetic complications. Angiotensin-converting enzyme inhibitors or angiotensin II receptors and β-blockers were the most used antihypertensive drugs, while the most frequently newly prescribed drugs were diuretics and calcium channel blockers.

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Prediction Models of Albumin Renal Excretion in Type 2 Diabetes Mellitus Patients

Revista de Chimie ◽

10.37358/rc.70.19.11.7650 ◽

2019 ◽

Vol 70 (11) ◽

pp. 3802-3807

Author(s):

Amorin Remus Popa ◽

Claudia Teodora Judea Pusta ◽

Cosmin Mihai Vesa ◽

Simona Bungau ◽

Camelia Liana Buhas ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Enzyme Inhibitors ◽

Angiotensin Converting Enzyme Inhibitors ◽

Converting Enzyme ◽

Angiotensin Ii Receptor ◽

Converting Enzyme Inhibitors ◽

Positive Correlation

Microalbuminuria is a cardiovascular risk factor in type 2 diabetes mellitus patients. It is very important to know which the predictor factors for albuminuria are, because these elements may be influenced by pharmacological measures. In our study we propose three models for the prediction of albumin glomerular excretion in a group of 446 type 2 diabetes mellitus patients: the clinical-biochemical model, the pharmacological model, and the integrative model that reunites the two models. In the clinical-biochemical model, albumin excretion was statistically significant influenced by HbA1c (positive correlation) and blood pressure (positive correlation). In the pharmacological model, albumin excretion was influenced by angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation). In the integrative model, the factors were HbA1c (positive correlation), diastolic blood pressure (positive correlation), angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation) and statins treatment (negative correlation). The prevalence of microalbuminuria was 16.14 %. Patients with microalbuminuria had statistically significant higher values of HbA1c, systolic blood pressure, diastolic blood pressure, triglycerides and lower values of HDL-cholesterol. A low glucose control was the most important risk factor for an increased albumin glomerular elimination. The importance of our study consists in the fact that all the elements that predict albuminuria can be influenced: HbA1c, blood pressure, therapy with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and statins.

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