[Prevalence and management of arterial hypertension in diabetic patients treated with insulin].
In small series of selected hypertensive diabetic patients the short-term benefit of antihypertensive treatments is well documented. The purpose of this study was to analyse the management of arterial hypertension in a cohort of 612 insulin-treated diabetic out-patients routinely and consecutively examined in a diabetologic clinic between January 1, 1985 and April 1, 1986. The prevalence of arterial hypertension (i.e. patients with blood pressure values greater than or equal to 160 and/or 95 mmHg or on antihypertensive treatment) was 38 per cent (232 patients). One hundred and eighty-two patients (29.7 per cent) received an antihypertensive treatment (one drug 78 per cent, two drugs 17 per cent, three drugs 5 per cent). In decreasing order of frequency these drugs were: beta-blockers, diuretics, central acting agents, angiotensin-converting enzyme inhibitors and calcium antagonists. In treated hypertensive diabetic patients the mean +/- SD systolic blood pressure (157.1 +/- 19.1 mmHg) and diastolic pressure (85.3 +/- 9.3 mmHg) remained higher than in patients without antihypertensive treatment (133.4 +/- 17.2 and 77.8 +/- 8.3 mmHg respectively). One hundred and forty-two diabetic patients still had blood pressure values greater than or equal to 160 and/or 95 mmHg during visits; 92 were on antihypertensive treatment, 50 were untreated. In hypertensive diabetic patients the mean total glycosylated haemoglobin (HbA1) level was higher than in normotensive diabetic patients (9 +/- 1.6 versus 8.6 +/- 1.8; P less than 0.05). Hypertensive insulin-treated diabetics are the most seriously ill patients, they are under inadequate care. Wrong choice of antihypertensive drugs, incorrect goals of blood pressure reduction, lack of information and education to improve compliance were the main reasons for the poor results of this study.
Billault
B
B
Service de Diabétologie, Hôpital Saint-Louis, Paris.
Boisvieux
J F
JF
Passa
P
P
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents; D007328:Insulin
Prévalence et prise en charge de l'hypertension artérielle chez les diabétiques traités par insuline.