Key result
Diabetes linked to ~128% higher odds of comorbid hypertension and worse blood pressure control.
Why the study?
Hypertension prevalence, awareness, treatment, and control in adults with self-reported diabetes compared with nondiabetic individuals in a real-world setting were not well characterized in Italy.
Cross-Sectional (n=47,217)
Yes
Odds Ratio: 2.28 (95% CI 2.12–2.46)
Absolute Event Rate: 80% vs 54.7%
p-value: p=<0.001
Despite higher rates of hypertension awareness and treatment, diabetic adults have significantly lower rates of adequate blood pressure control compared to nondiabetics in a real-world setting.
BP control gaps persist in diabetes despite awareness; leaves open optimal interventions for real-world improvement.
INTRODUCTION: Hypertesion is the leading cause of morbidity and mortality, worldwide, and its prevalence has been increasing in several countries, including Italy. AIMS: To assess hypertension prevalence, awareness, treatment, and control in a real-world sample of adults with self-reported diabetes compared with nondiabetic individuals. METHODS: Following the 2018 World Hypertension Day, a nationwide, cross-sectional epidemiological survey on cardiovascular risk factors ("Abbasso la Pressione!") in 3956 Italian pharmacies enrolled 47217 self-presenting volunteers (≥ 18 years). Participants underwent standardized blood pressure (BP) measurements and answered a questionnaire on cardiovascular risk factors and lifestyle habits. Questions included if they had an established diagnosis of diabetes, hypertension or were on a BP medication. Hypertension prevalence was defined as systolic BP ≥ 140 and/or diastolic BP ≥ 90 mmHg. A double definition for hypertension control based on the recent European and US guidelines on hypertension was applied. RESULTS: Diabetic individuals (N = 5695, 12%) had higher rates of hypertension prevalence (80% vs. 54.7%, p < 0.001), awareness (85.6% vs 77.3%, p < 0.001) and treatment (85.8% vs. 76.7%, p < 0.001), but lower hypertension control rates (36.1% vs. 39.6% according to the 2018 European guidelines, p < 0.001; 25.4% vs 30.8% according to the 2017 US guidelines, p < 0.001) than nondiabetics. Diabetic participants tended to be older, sedentary, overweight/obese, dyslipidemic men, with higher 10-years cardiovascular risk than nondiabetics (p < 0.001). Uncontrolled hypertension was associated with male gender, diabetes, body mass index, unhealthy lifestyle habits, and older age. CONCLUSIONS: Elevated hypertension awareness and treatment rates in diabetic adults do not translate into adequate BP control in the real world. Concomitant unfavorable metabolic features and unhealthy lifestyle habits might contribute to this observation.
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Feo et al. (2021) conducted a cross-sectional in Hypertension and Diabetes (n=47,217). Diabetes vs. Nondiabetic individuals was evaluated on Hypertension prevalence (OR 2.28, 95% CI 2.12-2.46, p=<0.001). Self-reported diabetes was associated with more than double the odds of comorbid hypertension compared to nondiabetics (80.0% vs 54.7%, OR 2.28), alongside lower rates of adequate blood pressure control.
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