Prevalence, impact and management of hypertension-mediated organ damage in type 2 diabetes patients

A A Romero-Secin; J Díez-Espino; M A Prieto-Díaz; V Pallares-Carratala; A Barquilla-García; R M Micó-Pérez; J Polo-García; S M Velilla-Zancada; V Martín-Sanchez; A Segura-Fragoso; L Ginel-Mendoza; V M Arce-Vazquez; S Cinza-Sanjurjo

doi:10.1016/j.semerg.2024.102220

Prevalence, impact and management of hypertension-mediated organ damage in type 2 diabetes patients

Semergen. 2024 Mar 29;50(6):102220. doi: 10.1016/j.semerg.2024.102220. Online ahead of print.

Affiliations

¹ Specialist in Family and Community Medicine, Colloto Health Clinic, Principality of Asturias Health Service, Asturias, Spain; Fundacion redGEDAPS, Spain.
² Fundacion redGEDAPS, Spain; Specialist in Family and Community Medicine, Tafalla Health Center, Tafalla, Navarrese Health Service, Navarra, Spain.
³ Specialist in Family and Community Medicine, Vallobín-La Florida Health Center, Principality of Asturias Health Service, Asturias, Spain.
⁴ Department of Medicine, Jaume I University, Castellon, Spain. Electronic address: pallares.vic@gmail.com.
⁵ Specialist in Family and Community Medicine, Trujillo Health Center, Extremadura Health Service, Cáceres, Spain.
⁶ Specialist in Family and Community Medicine, Fontanars dels Alforins Health Center, Xàtiva-Ontinyent Department of Health, Valencia, Spain.
⁷ Specialist in Family and Community Medicine, Casar de Cáceres Health Center, Extremadura Health Service, Cáceres, Spain.
⁸ Specialist in Family and Community Medicine, Joaquin Elizalde Health Center, Rioja Health Service, Logroño, La Rioja, Spain.
⁹ Institute of Biomedicine (IBIOMED), University of León, Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), León, Spain.
¹⁰ Epidemiology Unit, Semergen Research Agency, Madrid, Spain.
¹¹ Specialist in Family and Community Medicine, Ciudad Jardín Health Center, Málaga, Spain.
¹² Centro de investigación en medicina molecular y enfermedades crónicas (CIMUS), Universidad de Santiago de Compostela, Galicia, Spain.
¹³ Specialist in Family and Community Medicine, Milladoiro Health Centre, Health Area of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain; Networking Biomedical Research, Centre-Cardiovascular Diseases (CIBERCV), Santiago de Compostela, Spain.

PMID: 38554607
DOI: 10.1016/j.semerg.2024.102220

Abstract

Objective: To determine the prevalence, impact and management of hypertension-mediated organ damage (HMOD) according to the presence of type 2 diabetes (T2DM).

Methods: IBERICAN is an ongoing multicenter, observational and prospective study, including outpatients aged 18-85 years who attended the Primary Care setting in Spain. In this study, the prevalence, impact and management of HMOD according to the presence of T2DM at baseline were analyzed.

Results: At baseline, 8066 patients (20.2% T2DM, 28.6% HMOD) were analyzed. Among patients with T2DM, 31.7% had hypertension, 29.8% dyslipidemia and 29.4% obesity and 49.3% had ≥1 HMOD, mainly high pulse pressure (29.6%), albuminuria (16.2%) and moderate renal impairment (13.6%). The presence of T2DM significantly increased the risk of having CV risk factors and HMOD. Among T2DM population, patients with HMOD had more dyslipidemia (78.2% vs 70.5%; P=0.001), hypertension (75.4% vs 66.4%; P=0.001), any CV disease (39.6% vs 16.1%; P=0.001) and received more drugs. Despite the majority of types of glucose-lowering agents were more frequently taken by those patients with HMOD, compared to the total T2DM population, the use of SGLT2 inhibitors and GLP-1 receptor agonists was marginal.

Conclusions: In patients daily attended in primary care setting in Spain, one in five patients had T2DM and nearly half of these patients had HMOD. In patients with T2DM, the presence of HMOD was associated with a higher risk of CV risk factors and CV disease. Despite the very high CV risk, the use of glucose-lowering agents with proven CV benefit was markedly low.

Keywords: Agonistas del receptor GLP-1; Cardiovascular; Daño orgánico mediado por hipertensión arterial; Diabetes; GLP-1 receptor agonists; Hypertension-mediated organ damage; Inhibidores de los SGLT2; SGLT2 inhibitors.