Type 2 diabetes and high blood pressure- How explosive is the cocktail? -
I Epidemiology of type 2 diabetes and hypertension
II Risks for hypertensive patients with diabetes
III Guidelines position
Two diabetic patients out of three also suffer from hypertension
Worldwide epidemiology
1 billion hypertensive patients
387 million patients with type 2 diabetes
258 million hypertensive patients with type 2
diabetes
WHO 2013. IDF 2015. Ferrannini E, Cushman WC. Lancet. 2012;380(9841):601-610.
Excess cardiovascular risk in diabetic patients is attributable to coexistent hypertension
Ferrannini E, Cushman WC. Lancet. 2012;380(9841):601-610.
All-cause mortality
“Participants with hypertension at the time of diabetes diagnosis had higher rates of all-cause mortality and cardiovascular
disease than did people with diabetes without hypertension”
+72%Cardiovascul
ar disease event
+57%
Reduce mortality rate in patients with diabetes remains an important challenge
Type 2 diabetes increases mortality risk by two-fold, macrovascular disease is
the predominant cause of death
Nwaneri C et al. Br J Diabetes Vasc Dis. 2013;13:192-207.Gregg EW et al. N Engl J Med. 2014;370(16):1514-1523.
Type 2 diabetes is associated with twice higher risk of MI and 1.5 higher risk of
stroke
Early control of blood pressure in hypertensive diabetic patients is essential to avoid early risk
CV = Cardiovascular, MI = myocardial infarctionRetrospective cohort. n=15 665 hypertensive diabetic patients without coronary disease and without a history of stroke.Adjusted incidence RRs for stroke, myocardial infarction, and other major cardiovascular events were estimated based on the mean level of BP control in the year after onset of hypertension. O’Connor PJ et al. Diabetes Care. 2013;36(2):322-327.
A diabetic patient whose blood pressure is not controlled within a year after hypertension onset has a 30% increased risk of CV events at 3 years