November 1, 1994Diabetes Care
Prevalence of Arterial Hypertension in Diabetic Patients Before and After the JNC-V
Why the study?
Does the application of JNC-V criteria compared to WHO criteria increase the diagnosed prevalence of arterial hypertension in patients with diabetes?
Population
1,506 Caucasian patients with diabetes attending an outpatient clinic, comprising 957 with insulin-dependent…
Comparison
JNC-V blood pressure criteria for defining… vs WHO blood pressure criteria for defining…
Design
Cohort
Follow-up
3 years
Authors
Discussion
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Member takes
Implication
May expand hypertension diagnoses in diabetes under JNC-V criteria; leaves open whether lower thresholds improve outcomes in prospective studies.
Key Points
- This study aims to compare arterial hypertension prevalence in insulin-dependent and non-insulin-dependent diabetes patients based on different blood pressure criteria.
- Analyzed two Caucasian cohorts: 957 with IDDM and 549 with NIDDM.
- Blood pressure measured annually using a standard clinical sphygmomanometer.
- Patients classified as hypertensive based on average BP over a 3-year follow-up.
- IDDM prevalence rose from 15% to 42% in normoalbuminuric, from 26% to 52% in microalbuminuric, and from 61% to 79% in macroalbuminuric groups.
- NIDDM prevalence increased from 51% to 71% (normo-), 73% to 90% (micro-), and 82% to 93% (macroalbuminuria).
- Among untreated hypertensives, 78% of IDDM and 50% of NIDDM patients had stage 1 hypertension.
Structured PICO
Does the application of JNC-V criteria compared to WHO criteria increase the diagnosed prevalence of arterial hypertension in patients with diabetes?
P
Population
1,506 Caucasian patients with diabetes attending an outpatient clinic, comprising 957 with insulin-dependent diabetes mellitus (IDDM) (mean age 40, 53% men) and 549 with non-insulin-dependent diabetes mellitus (NIDDM) (mean age 60, 53% men).
I
Intervention
JNC-V blood pressure criteria for defining hypertension
C
Comparator
WHO blood pressure criteria for defining hypertension
O
Outcome
Prevalence of arterial hypertension
The adoption of JNC-V criteria significantly increases the prevalence of diagnosed arterial hypertension in diabetic patients compared to older WHO criteria, largely driven by isolated systolic hypertension.
Cite This Study
Tarnow et al. (1994) studied this question.