Hypertensive diabetic patients. Guidelines for conduct and their difficulties
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Data
2003-08
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Objective - To assess the effect of blood pressure (BP)
control and other cardiovascular risk factors in patients
with diabetes mellitus in a referral service for the treatment
of hypertension.
Methods - A retrospective study where diabetic pa-
tients (at least 2 fasting glucose levels above 126 mg/dL, use
of hypoglycemic agents or insulin, or both of these) were in-
cluded. They were evaluated at the first appointment (M1)
and at the last appointment (M2), regarding blood pressu-
re, body mass index (BMI), use of hypertensive drugs, glyce-
mia, total cholesterol (TC), creatinine, and potassium.
Results - Of 1,032 patients studied, 146 patients with a
mean age of 61.6 years had diabetes, and 27 were men
(18.5%). Mean follow-up was 5.5 years. BP values were
161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In
M1, 10.4% of the patients did not use medications, 50.6%
used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or
more drugs. In M2, these values were 10.9%, 39%, 39.7%,
and 10.4%, respectively. Diuretics were the most commonly
used medication, whereas angiotensin-converting enzyme
inhibitors (ACE inhibitors) were those drugs which
presented greater increase when comparing M1 to M2
(24.6% and 41.7%, respectively). Only 17,1% reached the
recommended goal (BP<130x85 mmhg). The other cardio-
vascular risk factors did not change significantly.
Conclusion - Our data reinforce the necessity of a
more aggressive approach in the treatment of these
patients, despite the social and economic difficulties in
adhering to treatment.
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Palavras-chave
Hypertension, Diabetes, Treatment
Citação
BARROSO, Weimar K. S. et al. Hypertensive diabetic patients. Guidelines for conduct and their difficulties. Arquivos Brasileiros de Cardiologia, São Paulo, v. 81, n. 2, p. 137-142, Aug. 2003.