The Prevalence of Hypertension in Diabetes Mellitus and the Effects of Hypertension on the Progression of Diabetes
Journal Title: Turkish Journal of Endocrinology and Metabolism - Year 1998, Vol 2, Issue 1
Abstract
Between the years 1990 and 1996, 802 patients with Diabetes Mellitus (DM) were scanned for hypertension prevalence and the effect of hypertension on diabetic complications. Over 6 years, 103 patients with IDDM and 699 patients with NIDDM were examined and it was found that the prevalence of hypertension was 45.53% and 71% of them were female. The percentage of hypertension in patients with IDDM was 17% and 45.77% in NIDDM patients. it was found that diabetes was prior to hyper tension in 68.4% of the cases and in 8.4% of the cases the onset of hypertension ac companied the onset of diabetes. While the duration of diabetes is important in the existence of hypertension in IDDM, age is not a significant factor. it has been ob served that a family history of hypertension and atherosclerotic heart disease is not frequent in hypertensive IDDM patients. in IDDM, hypertension significantly coexists with nephropathy. in NIDDM both the age of the patient and the duration of diabetes affect the existence of hypertension. Hypertension is more prevalent in female and obese NIDDM patients. A family history of hypertension and atherosclerotic hearth disease is more frequent in hypertensive NIDDM patients than normotensive ones. When the hypertensive diabetics that had the same glycemic control as normotensives and normotensive diabetics were compared prior to the onset of anti hypertensive therapy, it was observed that diabetic complications such as re tinopathy, neuropathy and renal damage, which were determined by proteinuria and Creatinin Clearance (CCr), were found to be more prominent in hypertensives than in normotensives in the initial examination. it was observed that the difference between the normotensives and the hypertensives receiving antihypertensive and lipid lowering drugs became insignificant w it h time. Both normotensives and hypertensives' albuminuria stage distribution changed with time. While normoalbuminuric patients decreased, microalbuminuric patients increased. Although the distribution of al buminuria stages in hypertensive diabetics receiving antihypertensive medication and in normotensive patients look similar, in detailed examination the decrease in mean CCr levels and increase on mean proteinuria levels were found to be more prominent in hypertensives. Atherosclerotic ECG changes were observed in increasing frequency with time in both groups, being more prominent in the hypertensive group. Triglyceride and total cholesterol levels that were higher before the onset of antihypertensive and lipid lowering therapy in hypertensives vvere lovvered to as levels similar to normotensives with time. Even the hypertensives that had the same glycemic control as normotensives and received lipid lowering and antihyper tensive therapy were more prone to develop renal damage and macrovascular complications compared to normotensives. In the existence of hypertension which accelerates nephropathy and macrovascular complications, being the most important factors in the survival of diabetic patients, it is very important to begin antihypertensive treatment at an early stage. in hypertensive diabetics progress of renal damage and atherosclerotic complications açcelerated by hypertension can not be completely prevented but can be slowed down with antihypertensive therapy.
Authors and Affiliations
Okan Onbaşı, Belgin Efe, Aysen Akalın, Medine Kebapçı, Kevser Onbaşı, Esat Erenoğlu
Keywords
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