In order to establish the prevalence of hypertension (according to both the JNC-V/ADA and the WHO/ISH criteria) in patients with insulin-dependent diabetes mellitus (IDDM), a group of 142 unselected young adults with IDDM from Northern Gran Canaria Island was cross-sectionally studied. The relationship of hypertension to diabetic nephropathy and lipid profile was also studied. Blood pressure, urinary albumin excretion and plasma lipids (total cholesterol with VLDL, LDL and HDL fractions, triglycerides and Lp(a)) were measured. The prevalence of hypertension was 11.9% (95% CI 6.5-17.3) with the WHO criteria (> 160/95 mmHg) versus 58.7% (50.5-66.9) with the JNC-V criteria (> 130/85 mmHg). The respective prevalences were 3.8 (0.0-8.1) versus 49.4% (38.0-60.7) in patients with normoalbuminuria (< or = 20 micrograms/min), 17.9 (2.7-33.0) versus 71.4% (53.6-89.3) in patients with microalbuminuria (21-200 micrograms/min), and 44.4 (9.0-69.9) versus 83.3% (64.3-100) in patients with macroalbuminuria (> 200 micrograms/min). The presence of hypertension and of micro or macroalbuminuria was associated with a worse lipid profile.
In conclusion: the new JNC-V criteria drastically increase the figures of prevalence of hypertension in young insulin-dependent diabetic adults. Early and aggressive antihypertensive treatment benefits at least those patients with incipient nephropathy.