Macrovascular and Microvascular Complications in Type 2 Diabetes Mellitus

Objective: Comorbidities in type 2 diabetes mellitus (T2DM) and hypertension share many pathophysiological links due to common risk factors and complications. Macrovascular complications, such as coronary heart disease (CHD), heart failure (HF) and peripheral arterial disease (PAD), are frequent both in diabetic and hypertensive patients. Hypertension also seems to accelerate the development and progression of microvascular complications (nephropathy, neuropathy and retinopathy) of T2DM. We aimed to evaluate the presence of macrovascular and microvascular complications in hypertensive T2DM patients vs. normotensive T2DM patients. Design and method: We collected the medical records of T2DM patients hospitalized in the Internal Medicine Department of an emergency referral hospital in Bucharest, Romania. The study was observational, retrospective and was carried out between January and June 2017. Results: Medical records of 226 T2DM patients (mean age 68.49 ± 10.56, range 37–93 years) were retrieved: 122 women (49.59%; mean age 69.92 ± 10.57, range 37–89 years) and 124 men (50.41%; mean age 66.28 ± 9.65, range 40–91 years). Patients were divided into: group A = 186 T2DM patients with hypertension (82.30%, mean age 68.33 ± 10.31, range 37–91): 105 women (56.45%) and 80 men (43.55%); group B = 60 T2DM patients without hypertension (17.70%; 68.96 ± 11.38, range 38–93): 17 women (28.30%) and 43 men (71.70%). Macrovascular complications: HF (43.01% vs. 51.66%) and CHD (44.08% vs. 53.33%) were less common in hypertensive T2DM patients, whereas PAD was more frequent (10.21% vs. 8.33%). Microvascular complications: nephropathy (11.29% vs. 3.33%), neuropathy (10.75% vs. 5%) and retinopathy (5.91% vs. 1.66%) were more frequent in hypertensive T2DM patients.Conclusions: Macrovascular complications (except PAD) were more frequent in normotensive T2DM patients. Microvascular complications and PAD were more frequent in hypertensive T2DM patients. HF was more common in hypertensive T2DM men, whereas CHD and PAD were more likely encountered in women. All macrovascular complications were more frequent in normotensive T2DM men vs. women. All microvascular complications were more frequent in hypertensive T2DM women vs. men. In normotensive subjects, only men had microvascular complications.