Hypertension control in diabetes patients in Kuwait

ABSTRACT

To study the prevalence of uncontrolled hypertension in the diabetic Kuwaiti patients and to assess factors related to this condition. A population based study of a total of 251 diabetic patients [T1DM and T2DM] followed up in diabetes out patient clinic at Al Amiri hospital in Kuwait. Patients were evaluated basically for the blood pressure control, and in addition to the routine biophysical data, we measured the glycated hemoglobin, lipid, renal profile, and urinary protein excretion. 142 patients [56.6%] found to have uncontrolled hypertension. Factors associated with uncontrolled hypertension were old age [54.4 +/- 11.2 vs. 43.8 +/- 16.6 years in normotensives, p = 0.0], being T2DM rather than T1DM [62.1% vs. 24.3%, p = 0.0], longer duration of DM [14.5 +/- 8.2 vs. 10.7 +/- 6.9 years in normotensives, p = 0.001], obesity [BMI 30.9 +/- 5.6 vs. 27.6 +/- 5.3, p = 0.00], having past history of hypertension [78.2% vs. 31.2%, p = 0.0], the presence of proteinuria [52.8% vs. 32.1%, p = 0.01] and the presence of diabetic retinopathy [43% vs. 29.4%, p = 0.027]. The number of antihypertensive medication used by the hypertensive group was higher [1.6 +/- 1.0 vs. 0.71 +/- 0.9, p =0.00]. Uncontrolled hypertension was not significantly related to the degree of diabetes control, the presence of dyslipidemia, coronary heart disease and the type of antidiabetic treatment. We conclude that the majority of the diabetic patients are having uncontrolled hypertension. Beside tight blood pressure control, other factors related to uncontrolled hypertension namely obesity and proteinuria should be managed and tightly treated as this may have positive impact on hypertension control