title: Prevalence of hypertension and dyslipidemia and their associations with micro- and macrovascular diseases in patients with diabetes in Taiwan: an analysis of nationwide data for 2000-2009.
abstract: OBJECTIVE
  Cardiovascular complication is the leading cause of mortality in patients with diabetes. Dyslipidemia and hypertension are the major risk factors contributing to cardiovascular disease (CVD). This study was carried out to investigate the prevalence of dyslipidemia and hypertension and their associations with microvascular and macrovascular complications in patients with type 2 diabetes in Taiwan.
  
  
  METHODS
  Health-care data and diagnostic codes were retrieved from the Taiwan Bureau of National Health Insurance claims files for the years 2000-2009. Based on these data the annual prevalences of dyslipidemia and hypertension were calculated and patients were stratified by age, gender, and diabetic complications.
  
  
  RESULTS
  In patients with diabetes, the prevalence of dyslipidemia increased with age, with the highest rate recorded in adults (inclusive of both genders) between 40 and 65 years of age (p for trend <0.001). The prevalence of hypertension also increased with age with the highest rate seen in adults (inclusive of both genders) >65 years of age (p for trend <0.001). The prevalence of stroke and CVD decreased gradually (p for trend 0.025 and <0.001, respectively), while the prevalence of peripheral vascular disease (PVD) increased in patients with diabetes during the study period (p for trend <0.001). The prevalence of dyslipidemia increased in diabetic patients with eye diseases and in men with nephropathies, but decreased in women with nephropathies during the study period. In contrast, the prevalence of dyslipidemia decreased in patients with macrovascular complications, including CVD and cerebrovascular disease (cerebrovascular accident), but increased in those patients with PVD (p for all trends <0.05). In diabetic patients with various macrovascular complications, except PVD, there was a decrease in the prevalence of hypertension in the past 10 years. The prevalence of hypertension increased in patients with microvascular complications including retinopathy, patients on dialysis (inclusive of both genders), and in men with nephropathy. The prevalence of hypertension along with dyslipidemia increased in patients with microvascular complications including retinopathy, patients on dialysis (inclusive of both genders), and in men with nephropathy; however, the rate decreased in all macrovascular complications except in PVD.
  
  
  CONCLUSIONS
  Although progressively increased prevalence of dyslipidemia and hypertension was observed in patients with diabetes in Taiwan, there was a decrease in the prevalence of stroke and CVD in the past 10 years. Among those with macrovascular diseases, except PVD, there was a trend of decreased prevalence of hypertension and dyslipidemia during the study period. In patients with microvascular diseases, prevalence of hypertension and dyslipidemia in patients with eye diseases increased in the past 10 years. More aggressive management of different risk factors is warranted in diabetic patients with various vascular diseases.
authors.affiliation: Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Li-Nien
authors.initials: LN
authors.lastname: Tseng
authors.forename: Yao-Hsien
authors.initials: YH
authors.lastname: Tseng
authors.forename: Yi-Der
authors.initials: YD
authors.lastname: Jiang
authors.forename: Chia-Hsuin
authors.initials: CH
authors.lastname: Chang
authors.forename: Ching-Hu
authors.initials: CH
authors.lastname: Chung
authors.forename: Boniface J
authors.initials: BJ
authors.lastname: Lin
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
authors.forename: Tong-Yuan
authors.initials: TY
authors.lastname: Tai
authors.forename: Wayne H-H
authors.initials: WH
authors.lastname: Sheu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D048909:Diabetes Complications / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology