Personal attributes that influence the adequate management of hypertension and dyslipidemia in patients with type 2 diabetes. Results from the DIAB-CORE Cooperation

Oct 6, 2012Cardiovascular diabetology

Personal factors linked to proper management of high blood pressure and cholesterol in people with type 2 diabetes

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Abstract

Among 1287 participants with type 2 diabetes, uncontrolled blood pressure and dyslipidemia were more prevalent in younger men with low body mass index and no history of cardiovascular disease.

Uncontrolled blood pressure was linked to male sex, low body mass index, no history of myocardial infarction, and specific study sites.
Uncontrolled blood lipid levels were associated with male sex, absence of myocardial infarction history, and study site.
Younger participants, men, those with a body mass index under 30 kg/m², and individuals without prior myocardial infarction or stroke had higher odds of not receiving hypertension treatment.
Men with dyslipidemia were less likely to receive lipid-lowering medication if they had not experienced a myocardial infarction.
The most recent studies showed a higher number of participants with well-controlled blood pressure and lipid levels.

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BACKGROUND: Hypertension and dyslipidemia are often insufficiently controlled in persons with type 2 diabetes (T2D) in Germany. In the current study we evaluated individual characteristics that are assumed to influence the adequate treatment and control of hypertension and dyslipidemia and aimed to identify the patient group with the most urgent need for improved health care.

METHODS: The analysis was based on the DIAB-CORE project in which cross-sectional data from five regional population-based studies and one nationwide German study, conducted between 1997 and 2006, were pooled. We compared the frequencies of socio-economic and lifestyle factors along with comorbidities in hypertensive participants with or without the blood pressure target of<140/90 mmHg. Similar studies were also performed in participants with dyslipidemia with and without the target of total cholesterol/HDL cholesterol ratio<5. Furthermore, we compared participants who received antihypertensive/lipid lowering treatment with those who were untreated. Univariable and multivariable logistic regression models were used to assess the odds of potentially influential factors.

RESULTS: We included 1287 participants with T2D of whom n=1048 had hypertension and n=636 had dyslipidemia. Uncontrolled blood pressure was associated with male sex, low body mass index (BMI), no history of myocardial infarction (MI) and study site. Uncontrolled blood lipid levels were associated with male sex, no history of MI and study site. The odds of receiving no pharmacotherapy for hypertension were significantly greater in men, younger participants, those with BMI<30 kg/m(2) and those without previous MI or stroke. Participants with dyslipidemia received lipid lowering medication less frequently if they were male and had not previously had an MI. The more recent studies HNR and CARLA had the greatest numbers of well controlled and treated participants.

CONCLUSION: In the DIAB-CORE study, the patient group with the greatest odds of uncontrolled co-morbidities and no pharmacotherapy was more likely comprised of younger men with low BMI and no history of cardiovascular disease.

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Personal attributes that influence the adequate management of hypertension and dyslipidemia in patients with type 2 diabetes. Results from the DIAB-CORE Cooperation

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