Self-Assessment of Outpatient Management of Hypertension in Diabetics

Abstract

Background: Hypertension remains a major problem in diabetics, with a strong prevalence, and a high rate of uncontrolled subjects despite the combination of several therapeutic classes. Aims: To carry out an evaluation of hypertension management in a group of diabetics Methods: We conducted a retro-cross-sectional study including 200 patients by analyzing the data provided in the medical files and responding to an evaluation grid. Results: We included 200 patients whose were type 1 diabetics (T1D) in 21.5% of cases and type 2 diabetics (T2D) in 78.5% of cases. The mean age was of 36 ± 10.9 years in the T1D group and 56.4 ± 9.7 years in the T2D group. Hypertension was present in 34.9% of T1D and 56.7% of T2D.   The BP was taken only in 61% of patients and in patients with hypertension in 71.7 % and in 65.5% of cases the SBP <130 mmHg and 60.6% the DBP <80 mmHg. Microalbuminuria was found in 30% of T1Ds and 31.7% of T2D. The frequency of consultations was quarterly in 9% of cases, every 4 months in 67% of cases and every 6 months in 24% of cases.  The average number of drugs prescribed per day was 2.96 ± 1.7 (1 to 9 drugs). 54.8% of hypertensive patients were on a single class of antihypertensive drugs. 34.8% of them received dual therapy and 7.6% triple therapy. Angiotensin converting enzyme inhibitors (ACEI) were prescribed in 65.3%. Concerning adherence to treatment: 51% of diabetics know the name of their medication and 77% know its indication. Conclusion: The hypertensive diabetic is a patient at generally high cardiovascular risk but whose level of risk deserves to be specifically assessed. Management remains the main challenge with the main objective of reducing cerebrovascular morbidity and mortality.