1. Management of hypertension and diabetes mellitus by cardiovascular and endocrine physicians: a China registry.
- Author
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Song J, Sheng CS, Huang QF, Li LH, Ma CS, Guo XH, Ji LN, and Wang JG
- Subjects
- Aged, Albuminuria etiology, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Blood Pressure, China, Cross-Sectional Studies, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 complications, Drug Therapy, Combination, Female, Glycated Hemoglobin metabolism, Humans, Hypertension complications, Hypertension physiopathology, Male, Middle Aged, Practice Patterns, Physicians', Registries, Renin-Angiotensin System, Surveys and Questionnaires, Antihypertensive Agents therapeutic use, Cardiology methods, Diabetes Mellitus, Type 2 drug therapy, Endocrinology methods, Hypertension drug therapy, Hypoglycemic Agents therapeutic use
- Abstract
Objective: We investigated hypertension and diabetes mellitus in two management settings, namely cardiology and endocrinology, and their associations with albuminuria while accounting for the management of these two diseases., Methods: Our multicentre registry included patients (≥20 years) seen for hypertension in cardiology or for diabetes mellitus in endocrinology. We administered a questionnaire and measured blood pressure, glycosylated haemoglobin A1c and albuminuria., Results: Presence of both hypertension and diabetes was observed in 32.9% of hypertensive patients in cardiology (n = 1291) and 58.9% of diabetic patients in endocrinology (n = 1168). When both diseases were present, the use of combination antihypertensive therapy [odds ratio (OR) 0.31, P < 0.0001] and inhibitors of the renin-angiotensin system (OR 0.66, P = 0.0009) was less frequent in endocrinology than cardiology, and the use of combination antidiabetic therapy (OR 0.16, P < 0.0001) was less frequent in cardiology than endocrinology. The control of hypertension and diabetes, however, was not different between the two management settings (P ≥ 0.21), regardless of the therapeutic target (SBP/DBP < 140/90 or 130/80 mmHg and glycosylated haemoglobin A1c <7.0 or 6.5%). The prevalence of albuminuria was higher (P ≤ 0.02) in the presence of both diseases (23.3%) than those with either hypertension (12.6%) or diabetes alone (15.9%)., Conclusion: Hypertension and diabetes mellitus were often jointly present, especially in the setting of endocrinology. The management was insufficient on the use of combination antihypertensive therapy and inhibitors of the renin-angiotensin system in endocrinology and for combination antidiabetic therapy in cardiology, indicating a need for more intensive management and better control of both clinical conditions.
- Published
- 2016
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