Does glycemic control reduce cardiovascular complications

ABSTRACT

To evaluate the association between glycemic control and hypertensive crisis. A Cross Sectional Study. Cardiology Unit, Salmaniya Medical Complex. One hundred forty-five patients with diabetes mellitus, above 18 years admitted from 1 June 2010 to 31 December 2010 for a hypertensive crisis were reviewed. A control group consisted of 145 diabetic patients, age and sex matched, without hypertensive crisis were recruited for the study. A hypertensive crisis is classified into urgency or emergency, based on the absence or presence of acute target organ involvement. Glycated hemoglobin [HbAlc] level of <53 mmol/mol is the threshold for good glycemic control. The relationship between various clinical presentation and HbAlc was assessed. One hundred forty-five were reviewed, 87 [60%] were males and 58 [40%] were females. Twenty-six [18%] of the crisis group had HbAlc of < 53 mmol/mol; 75 [52%] of the control subjects had HBAlc <53 mmol/mol, [P value<0.0001]. Among the hypertensive crisis group, the rate of hypertensive emergencies, 84 [58%], was greater than those of hypertensive urgencies, 61 [42%]. Left ventricular failure [LVF] was the most common clinical presentation. Poor glycemic control was closely related to hypertensive emergency [P value=0.042]. Patients with HBAlc <53 mmol/mol had lower rates of hypertensive emergencies than those with HBAlc >53mmol/mol, 11 [42%] and 75 [63%], respectively. It was found that hypertensive patients with good glycemic control are at a lesser risk of getting emergency hypertensive crisis. Controlling diabetes may confer protection against hypertensive crisis and in particular, emergencies and the related cardiovascular complications