A nationwide assessment of blood pressure control and the associated factors in Chinese type 2 diabetes mellitus patients

J Clin Hypertens (Greenwich). 2019 Nov;21(11):1654-1663. doi: 10.1111/jch.13675. Epub 2019 Oct 11.

Abstract

A subgroup analysis of the nationwide, cross-sectional 3B STUDY was performed to understand the current blood pressure (BP) control status and treatment patterns in Chinese diabetes patients as well as to identify factors associated with BP control. The demographic data, anthropometric parameters, and laboratory results were collected from 24 512 type 2 diabetes patients. The BP goal was a systolic BP <130 mm Hg and a diastolic BP <80 mm Hg regardless of a history of hypertension or current antihypertensive treatment. The overall prevalence of hypertension was 59.9% with geographical differences. Among the diabetes patients with hypertension, 76.9% received antihypertensive medicines. Calcium channel blockers (39.3%), angiotensin II receptor antagonists (26.6%), and then β-blockers (14.0%) or angiotensin-converting enzyme inhibitors (13.6%) were frequently used for BP control. Only 17.5% (n = 2658) of diabetes patients with hypertension reached the recommended target BP. Body mass index <24 kg/m2 , urban resident, frequent physical activity, good adherence to medication, comorbidity with cardiovascular disease, achieving glycemic goal (HbA1c <7.0%), achieving lipid goal (low-density lipoprotein cholesterol <2.59 mmol/L) were independent factors that predicted achievement of target BP goal. On the contrary, comorbidity with chronic kidney disease predicted failure to achieve target BP goal. Patients who were treated in a cardiology department or lived in the North were more likely to achieve BP goals. A considerable proportion of diabetic patients failed to achieve guideline-recommended BP targets. More aggressive efforts should be made to overcome the diverse barriers and facilitate the optimization of diabetes management.

Keywords: blood pressure control; glycated hemoglobin; hypertension; type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents* / classification
  • Antihypertensive Agents* / therapeutic use
  • Blood Pressure Determination* / methods
  • Blood Pressure Determination* / standards
  • Body Mass Index
  • China / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / physiopathology
  • Diabetes Mellitus, Type 2* / therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / physiopathology
  • Male
  • Middle Aged
  • Needs Assessment
  • Patient Care Management / methods
  • Patient Care Management / standards
  • Patient Care Planning / standards
  • Patient Compliance
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology

Substances

  • Antihypertensive Agents
  • Glycated Hemoglobin A