Key result
Antihypertensive monotherapy is linked to BP control in ~63% of patients versus polytherapy, especially without renal impairment.
Why the study?
The utilization patterns of anti-hypertensive drugs and blood pressure control among diabetic-hypertensive patients with and without reduced renal function were not well characterized.
What are the utilization patterns of anti-hypertensive drugs and rates of blood pressure control among diabetic-hypertensive patients with and without reduced renal function?
Observational (n=50)
No
What are the utilization patterns of anti-hypertensive drugs and rates of blood pressure control among diabetic-hypertensive patients with and without reduced renal function?
Absolute Event Rate: 63.15% vs 33.33%
There is suboptimal use of combination antihypertensive therapy and inadequate BP control in diabetic-hypertensive patients, particularly those with reduced renal function.
BP control lower with reduced renal function; supports closer monitoring in this subgroup but leaves optimal regimens open for prospective study.
Background: The benefits of optimum blood pressure (BP) control in patients with diabetes exceed the benefits of glycaemic control and extend to the prevention of both macro-vascular and micro-vascular complications in patients suffering from both hypertension and diabetes mellitus. Aims & Objective:To investigate the utilization patterns of anti-hypertensive drugs and to evaluate blood pressure (BP) control among diabetic-hypertensive patients with and without reduced renal function. Material and Methods:A prospective, observational study carried out at medicine department of SBKS Medical College and Research Centre, Piparia.The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function.Results: Total 63 antihypertensive medication episodes were prescribed for 50 patients.Out of which 76% patients were receiving 1 drug, 22% receiving 2 drugs and 2% receiving 3 drugs of different antihypertensive class.Most patients were receiving Angiotensin-Converting-Enzyme-Inhibitors (ACE-I)/Angiotensin-Receptor-Blockers (ARBs) (60%), followed by CCBs (24%), beta-blockers (20%), and diuretics (16%).Patients on monotherapy were mostly receiving ACE-I/ARB (65.78%).Beta blockers were more commonly prescribed in patients with reduced renal function (p=0.005).BP control was achieved in 63.15% patients in monotherapy and 33.33% in polytherapy group.Control of systolic and diastolic BP was significantly higher in patients without reduced renal function than patients with reduced renal function (p<0.05).Conclusion: There was suboptimum use of combination therapy among diabetic-hypertensive patients in general and specifically in developing countries as reflected by control achieved in systolic and diastolic BP which requires concern of all healthcare professionals.
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Shah et al. (2012) conducted an observational in Hypertension and diabetes mellitus (n=50). Antihypertensive monotherapy vs. Antihypertensive polytherapy was evaluated on Blood pressure control. Antihypertensive monotherapy achieved blood pressure control in 63.15% of patients compared to 33.33% on polytherapy, with significantly better control in patients without reduced renal function (p<0.05).
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