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Blood Pressure Control Has Improved in People with and without Type 2 Diabetes but Remains Suboptimal: A Longitudinal Study Based on the German DIAB-CORE Consortium.

Rückert IM, Baumert J, Schunk M, Holle R, Schipf S, Völzke H, Kluttig A, Greiser KH, Tamayo T, Rathmann W, Meisinger C - PLoS ONE (2015)

Bottom Line: Pulse pressure (PP) was markedly higher in persons with T2D than in persons without T2D (64.14 mmHg in prevalent T2D compared to 52.87 mmHg in non-T2D at baseline) and did not change much between the two examinations.Blood pressure in men had improved more than in women at follow-up, however, men still had higher mean SBP than women at follow-up.Blood pressure management has developed positively during past years in Germany.

View Article: PubMed Central - PubMed

Affiliation: Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Center for Diabetes Research (DZD e.V.), Partner Neuherberg, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.

ABSTRACT

Background: Hypertension is a very common comorbidity and major risk factor for cardiovascular complications, especially in people with Type 2 Diabetes (T2D). Nevertheless, studies in the past have shown that blood pressure is often insufficiently controlled in medical practice. For the DIAB-CARE study, we used longitudinal data based on the German DIAB-CORE Consortium to assess whether health care regarding hypertension has improved during the last decade in our participants.

Methods: Data of the three regional population-based studies CARLA (baseline 2002-2006 and follow-up 2007-2010), KORA (baseline 1999-2001 and follow-up 2006-2008) and SHIP (baseline 1997-2001 and follow-up 2002-2006) were pooled. Stratified by T2D status we analysed changes in frequencies, degrees of awareness, treatment and control. Linear mixed models were conducted to assess the influence of sex, age, study, and T2D status on changes of systolic blood pressure between the baseline and follow-up examinations (mean observation time 5.7 years). We included 4,683 participants aged 45 to 74 years with complete data and accounted for 1,256 participants who were lost to follow-up by inverse probability weighting.

Results: Mean systolic blood pressure decreased in all groups from baseline to follow-up (e.g. - 8.5 mmHg in those with incident T2D). Pulse pressure (PP) was markedly higher in persons with T2D than in persons without T2D (64.14 mmHg in prevalent T2D compared to 52.87 mmHg in non-T2D at baseline) and did not change much between the two examinations. Awareness, treatment and control increased considerably in all subgroups however, the percentage of those with insufficiently controlled hypertension remained high (at about 50% of those with hypertension) especially in prevalent T2D. Particularly elderly people with T2D often had both, high blood pressure ≥140/90 mmHg and a PP of ≥60 mmHg. Blood pressure in men had improved more than in women at follow-up, however, men still had higher mean SBP than women at follow-up.

Conclusion: Blood pressure management has developed positively during past years in Germany. While hypertension prevalence, awareness and treatment were substantially higher in participants with T2D than in those without T2D at follow-up, hypertension control was achieved only in about half the number of people in each T2D group leaving much room for further improvement.

No MeSH data available.


Related in: MedlinePlus

Sex-stratified frequencies of controlled treated, uncontrolled, known but untreated and unknown hypertension in participants with prevalent and (future) incident T2D in the baseline and follow-up examinations.Hypertension was defined as blood pressure ≥140/90 mmHg. Numbers are weighted and given as %.
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pone.0133493.g001: Sex-stratified frequencies of controlled treated, uncontrolled, known but untreated and unknown hypertension in participants with prevalent and (future) incident T2D in the baseline and follow-up examinations.Hypertension was defined as blood pressure ≥140/90 mmHg. Numbers are weighted and given as %.

Mentions: Trends of blood pressure treatment and control are illustrated in S2 Fig and Fig 1: In the baseline examinations, a much greater percentage of participants without T2D was free of hypertension than of those with T2D (42% vs. 15%). Compared to baseline, the percentage of participants with high blood pressure increased slightly in participants without T2D, the percentage with controlled treated hypertension more than doubled (from 10 to 26%), while the number of persons with insufficiently treated hypertension approximately stayed the same (18%). Both untreated known and untreated unknown hypertension became less frequent.


Blood Pressure Control Has Improved in People with and without Type 2 Diabetes but Remains Suboptimal: A Longitudinal Study Based on the German DIAB-CORE Consortium.

Rückert IM, Baumert J, Schunk M, Holle R, Schipf S, Völzke H, Kluttig A, Greiser KH, Tamayo T, Rathmann W, Meisinger C - PLoS ONE (2015)

Sex-stratified frequencies of controlled treated, uncontrolled, known but untreated and unknown hypertension in participants with prevalent and (future) incident T2D in the baseline and follow-up examinations.Hypertension was defined as blood pressure ≥140/90 mmHg. Numbers are weighted and given as %.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4519307&req=5

pone.0133493.g001: Sex-stratified frequencies of controlled treated, uncontrolled, known but untreated and unknown hypertension in participants with prevalent and (future) incident T2D in the baseline and follow-up examinations.Hypertension was defined as blood pressure ≥140/90 mmHg. Numbers are weighted and given as %.
Mentions: Trends of blood pressure treatment and control are illustrated in S2 Fig and Fig 1: In the baseline examinations, a much greater percentage of participants without T2D was free of hypertension than of those with T2D (42% vs. 15%). Compared to baseline, the percentage of participants with high blood pressure increased slightly in participants without T2D, the percentage with controlled treated hypertension more than doubled (from 10 to 26%), while the number of persons with insufficiently treated hypertension approximately stayed the same (18%). Both untreated known and untreated unknown hypertension became less frequent.

Bottom Line: Pulse pressure (PP) was markedly higher in persons with T2D than in persons without T2D (64.14 mmHg in prevalent T2D compared to 52.87 mmHg in non-T2D at baseline) and did not change much between the two examinations.Blood pressure in men had improved more than in women at follow-up, however, men still had higher mean SBP than women at follow-up.Blood pressure management has developed positively during past years in Germany.

View Article: PubMed Central - PubMed

Affiliation: Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Center for Diabetes Research (DZD e.V.), Partner Neuherberg, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.

ABSTRACT

Background: Hypertension is a very common comorbidity and major risk factor for cardiovascular complications, especially in people with Type 2 Diabetes (T2D). Nevertheless, studies in the past have shown that blood pressure is often insufficiently controlled in medical practice. For the DIAB-CARE study, we used longitudinal data based on the German DIAB-CORE Consortium to assess whether health care regarding hypertension has improved during the last decade in our participants.

Methods: Data of the three regional population-based studies CARLA (baseline 2002-2006 and follow-up 2007-2010), KORA (baseline 1999-2001 and follow-up 2006-2008) and SHIP (baseline 1997-2001 and follow-up 2002-2006) were pooled. Stratified by T2D status we analysed changes in frequencies, degrees of awareness, treatment and control. Linear mixed models were conducted to assess the influence of sex, age, study, and T2D status on changes of systolic blood pressure between the baseline and follow-up examinations (mean observation time 5.7 years). We included 4,683 participants aged 45 to 74 years with complete data and accounted for 1,256 participants who were lost to follow-up by inverse probability weighting.

Results: Mean systolic blood pressure decreased in all groups from baseline to follow-up (e.g. - 8.5 mmHg in those with incident T2D). Pulse pressure (PP) was markedly higher in persons with T2D than in persons without T2D (64.14 mmHg in prevalent T2D compared to 52.87 mmHg in non-T2D at baseline) and did not change much between the two examinations. Awareness, treatment and control increased considerably in all subgroups however, the percentage of those with insufficiently controlled hypertension remained high (at about 50% of those with hypertension) especially in prevalent T2D. Particularly elderly people with T2D often had both, high blood pressure ≥140/90 mmHg and a PP of ≥60 mmHg. Blood pressure in men had improved more than in women at follow-up, however, men still had higher mean SBP than women at follow-up.

Conclusion: Blood pressure management has developed positively during past years in Germany. While hypertension prevalence, awareness and treatment were substantially higher in participants with T2D than in those without T2D at follow-up, hypertension control was achieved only in about half the number of people in each T2D group leaving much room for further improvement.

No MeSH data available.


Related in: MedlinePlus