Key result
Combined diabetes and hypertension linked to worse BP and glucose control versus either condition alone.
Why the study?
Patients with both diabetes and hypertension face greater health risks than those with either condition alone, but less attention has been paid to their management outcomes.
Cohort (n=35,635)
Patients with comorbid hypertension and diabetes have poorer blood pressure and glucose control outcomes over time compared to those with either condition alone.
Background: Patients with both diabetes and hypertension could face more health risks than those with either condition alone, and less attention has been paid to their management outcomes, so this study may be the first to specifically address this problem. We aimed to examine the management outcomes of blood pressure (BP) in hypertensive patients with/without diabetes and fasting plasma glucose (FPG) in diabetic patients with/without hypertension. Methods: Follow-up data were obtained from the National Basic Public Health Service Project in Sanming (2017– 2021). A total of 25,795 adults with hypertension only, 4111 adults with diabetes only, and 5729 comorbid adults (namely, hypertensive patients with diabetes) were included. Generalized estimating equations were applied. Results: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension only both dropped significantly (Coef. = − 0.00088, P < 0.001; Coef. = − 0.00081, P < 0.001). DBP in comorbid patients decreased considerably (Coef. = − 0.00033, P < 0.001). Pulse pressure in comorbid patients grew rapidly (Coef. = 0.00044, P < 0.001). BP control rate in patients with hypertension only increased significantly (OR = 1.00039, P < 0.001). FPG control rates in diabetic patients with/without hypertension grew markedly (OR = 1.00013, P < 0.001; OR = 1.00020, P < 0.001). Comorbid patients had lower baseline SBP and DBP but higher latest SBP than patients with hypertension only (Coef. = − 1.18872, P < 0.001; Coef. = − 1.16049, P < 0.001; Coef. = 1.0634, P < 0.001). Comorbid patients had lower baseline BP and FPG control rates than those with either condition alone, and differences were greater at the latest follow-up (OR = 0.28086, P < 0.001; OR = 0.91012, P = 0.049; OR = 0.04020, P < 0.001; OR = 0.69465, P < 0.001). Conclusion: BP and FPG management outcomes have achieved progress. Comorbid patients have poorer performance than patients with either disease alone in BP levels especially the SBP level and control rates of SBP, DBP, and FPG. Future studies should be conducted using national data and include more confounding factors.
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Xu et al. (2022) conducted a cohort in Hypertension, Diabetes, and Comorbidity (n=35,635). Comorbidity (Hypertension and Diabetes) vs. Hypertension only or Diabetes only was evaluated on Blood pressure and fasting plasma glucose levels and control rates (p=<0.001). Having both diabetes and hypertension was associated with significantly poorer blood pressure and fasting plasma glucose control rates over 4 years compared to having either condition alone (P<0.001).
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