title: Personal attributes that influence the adequate management of hypertension and dyslipidemia in patients with type 2 diabetes. Results from the DIAB-CORE Cooperation.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH) and German Center for Diabetes Research (DZD e,V,), Ingolstädter Landstrasse 1, D-85764, München/Neuherberg, Germany. ina-maria.rueckert@helmholtz-muenchen.de
authors.forename: Ina-Maria
authors.initials: IM
authors.lastname: Rückert
authors.forename: Werner
authors.initials: W
authors.lastname: Maier
authors.forename: Andreas
authors.initials: A
authors.lastname: Mielck
authors.forename: Sabine
authors.initials: S
authors.lastname: Schipf
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Alexander
authors.initials: A
authors.lastname: Kluttig
authors.forename: Karin-Halina
authors.initials: KH
authors.lastname: Greiser
authors.forename: Klaus
authors.initials: K
authors.lastname: Berger
authors.forename: Grit
authors.initials: G
authors.lastname: Müller
authors.forename: Ute
authors.initials: U
authors.lastname: Ellert
authors.forename: Hannelore
authors.initials: H
authors.lastname: Neuhauser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Teresa
authors.initials: T
authors.lastname: Tamayo
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.forename: Silke
authors.initials: S
authors.lastname: Andrich
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008019:Life Style; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D008055:Lipids