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Epidemiology of Hypertension in Diabetes

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Diabetes and Hypertension

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Given the prevalence and impact of hypertension on vascular disease in diabetic patients, the prevalence, awareness, treatment, and control of hypertension in diabetes has important implications for healthcare policy and professional guidelines. This report examines changes in the clinical epidemiology of hypertension in diabetes from 1988 to 2008 using the National Health and Nutrition Examination Survey database subdivided into 1988–1994, 1999–2004, and 2005–2008. Over time, prevalent hypertension, defined as blood pressure (BP) ≥140/≥90 mmHg or self-reported hypertension treatment, increased from 51 % to 66 %, p < 0.001. BP declined from 145.2/74.7 to 136.5/69.7, p < 0.001, among all patients with diabetes and hypertension. The reduction in BP reflected improvements in hypertension awareness (83–92 %, p < 0.001), treatment (73–87 %, p < 0.001), proportion of treated patients controlled (48–62 %, p < 0.01), and controlled to <140/<90 (35.5–54.6 %, p < 0.001). BP control to the more stringent target of <130/<80 rose (18–36 %, p < 0.01). The proportion of patients with diabetes and hypertension who had normal BP (<120/<80) increased from 10.7 % to 20.8 %, whereas the proportion with Stage 2 hypertension (BP ≥160/≥100) decreased from 23.5 % to 14.5 % (both p < 0.001). Hypertension control improved, although body mass index increased from 31.3 to 33.1 kg/m2, p < 0.001, and likely reflected a decrease in hypertension treated with 0–1 and an increase in treatment with ≥3 antihypertensive medications. Time trends in the clinical epidemiology of hypertension among patients with diabetes are positive, except for prevalence, and parallel findings reported in all patients with hypertension over the same time period.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Avenue, RT1230, Charleston, SC, 29425, USA

    Brent M. Egan M.D., Yumin Zhao & Walter A. Brzezinski

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  1. Brent M. Egan M.D.
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  2. Yumin Zhao
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  3. Walter A. Brzezinski
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Correspondence to Brent M. Egan M.D. .

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Editors and Affiliations

  1. County Hospital, Division of Endocrinology,, SUNY-Downstate and Kings, 450 Clarkson Ave., Brooklyn, 11203, New York, USA

    Samy I. McFarlane

  2. ASH Comprehensive Hypertension Center, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC1027, Chicago, 60637, Illinois, USA

    George L. Bakris

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© 2012 Springer Science+Business Media New York

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Egan, B.M., Zhao, Y., Brzezinski, W.A. (2012). Epidemiology of Hypertension in Diabetes. In: McFarlane, S., Bakris, G. (eds) Diabetes and Hypertension. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-357-2_1

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  • DOI: https://doi.org/10.1007/978-1-60327-357-2_1

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-356-5

  • Online ISBN: 978-1-60327-357-2

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