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. 2021 Sep;23(9):1776-1785.
doi: 10.1111/jch.14352. Epub 2021 Aug 21.

Uncontrolled hypertension in patients with type 2 diabetes: What are the correlates?

Soghra Rabizadeh  1 , Bahareh Gholami  1 , Shiva Mahmoudzadeh Kani  1 , Armin Rajab  1 , Hossein Farrokhpour  1 , Alireza Esteghamati  1 , Manouchehr Nakhjavani  1
Affiliations

Uncontrolled hypertension in patients with type 2 diabetes: What are the correlates?

Soghra Rabizadeh et al. J Clin Hypertens (Greenwich). 2021 Sep.

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.

Keywords: BMI; hypertension; metabolic syndrome; non-HDL cholesterol; pulse pressure; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The comparison of odds ratios of non‐HDL‐C level and blood control status based on serum triglyceride levels. Reference group: non‐HDL‐C = < 130 mg/Dl. *Significant difference with reference group (p < .05). TG: Triglyceride; non‐HDL‐C: none high‐density lipoprotein cholesterol
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