Key result
Real-world hypertension care achieves blood pressure targets in only ~45% of patients.
Why the study?
Real-world evidence from Germany evaluating the management of hypertensive patients with type 2 diabetes at high cardiovascular risk is limited.
Observational (n=186,991)
Yes
A substantial proportion of patients with hypertension and type 2 diabetes in Germany do not achieve blood pressure targets in routine clinical care, highlighting significant gaps in the implementation of guideline-directed therapy.
BP targets unmet in most German patients with hypertension and T2D; leaves open effective strategies to close real-world implementation gaps.
Introduction and Objective: Patients (pts) with type 2 diabetes (T2D) and hypertension (HTN) are at high risk for premature mortality and cardiovascular events. Therefore, achieving blood pressure (BP) targets is a key protective strategy. Real-world evidence from Germany evaluating the management of hypertensive pts is still limited. MapHTN characterizes the epidemiology, treatment patterns, and regional variation of controlled (cHTN) and uncontrolled HTN (uHTN). Pts with T2D were analyzed as a predefined subgroup. Methods: We performed a retrospective secondary analysis of electronic medical records (EMR) data from general practitioners, cardiologists, and internists in Germany. Adults (≥18 years) with a documented HTN diagnosis were included. Pts were categorized into cHTN or uHTN based on mean recorded BP values (target ≤140/90 mmHg). Baseline characteristics, BP measurements, antihypertensive treatments and comorbidities were analyzed across cohorts. Medication exposure was identified via ATC codes; T2D and comorbidities were identified using ICD-10-GM codes. Results: In 2024, a total of 186,991 pts with HTN had evaluable BP values. Prescribing patterns differed between cHTN and uHTN groups, and a substantial proportion of pts remained uncontrolled despite treatment with ≥2 antihypertensive drug classes. Overall, 69,348 (37.1%) pts had a documented diagnosis of T2D. 45.2% of all HTN pts and 50.3% of pts with T2D were classified as cHTN, while 54.8% and 49.7%, respectively, did not meet BP targets and were categorized as uHTN. Conclusion: MapHTN identifies gaps in achieving BP targets in routine clinical care in Germany, including pts with T2D. These findings highlight the need to strengthen guideline directed therapy, improve care coordination and the implementation of established disease management programs. The T2D subgroup analysis provides clinically relevant insights into the combined management of HTN and T2D and may inform targeted strategies to address care gaps in this high-risk population. Disclosure Y. Lee-Barkey: Speaker's Bureau; Current; AstraZeneca. Research Support; Current; AstraZeneca, Amgen Inc. Speaker's Bureau; Current; Amgen Inc. Research Support; Ended; Applied Therapeutics. Speaker's Bureau; Ended; Boehringer Ingelheim International GmbH. Research Support; Current; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novartis AG, Novo Nordisk. Advisory Panel; Current; Sanofi. J. Weil: Advisory Panel; Current; AstraZeneca. F.M. Mader: Advisory Panel; Current; AstraZeneca. C. Köhler: Employee; Current; AstraZeneca. E. Ziegler: Employee; Current; AstraZeneca. M. Roos: None.
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Lee-Barkey et al. (2026) conducted an observational in Hypertension and Type 2 Diabetes (n=186,991). Antihypertensive treatment was evaluated on Controlled hypertension (target ≤140/90 mmHg). In a real-world German cohort of 186,991 adults with hypertension, blood pressure targets were met by only 45.2% of all patients and 50.3% of the 69,348 patients with comorbid type 2 diabetes.
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