TREATMENT AND CONTROL OF HYPERCHOLESTEROLEMIA AND HYPERTENSION IN PERSONS WITH AND WITHOUT DIABETES

Our object was to examine whether the frequency of medical treatment f or hypercholesterolemia or hypertension and the frequency of control o f these conditions were different in persons with and without known di abetes. Subjects 43-86 years of age with (n = 376) and without (n = 4, 420) known diabetes participated in the Beaver Dam Eye Study. Hypercho lesterolemia was defined as a serum cholesterol of greater than or equ al to 6.2 mmol/L or use of lipid-lowering agents, and hypertension was defined as a systolic blood pressure greater than or equal to 140 mm Hg or diastolic blood pressure greater than or equal to 90 mm Hg or us e of antihypertensive medications. Those subjects with diabetes had a similar frequency of hypercholesterolemia (42.8% versus 43.3%, P =.22) and a significantly higher frequency of hypertension (73.1% versus 48 .3 %, P <.0001) than those without diabetes. In those who were hyperch olesterolemic, subjects with diabetes were slightly more likely to use lipid-lowering agents than those without diabetes (14.6% versus 9.8%, P =.05). In those who were hypertensive, subjects with diabetes were more likely to be on antihypertensive medications than those without d iabetes (77.4% versus 57.0%, P <.0001). After adjusting for sociodemog raphic and cardiovascular disease risk factors, the odds of a particip ant with hypercholesterolemia receiving treatment with lipid-lowering agents was 1.61 (95% confidence intervals [CI] = 0.98, 2.65) and the o dds of a participant with hypertension receiving treatment with antihy pertensive medications was 2.32 (95% CI = 1.68, 3.20) for those with d iabetes versus those without. The frequency of medical control of hype rtension was higher (50.5%) than the frequency of medical control of h ypercholesterolemia (33.0%) in subjects without diabetes; in those wit h diabetes the frequency of control of hypertension (42.9%) and hyperc holesterolemia (26.1%) was not statistically different (P =.26). These data show that persons who have older-onset diabetes as well as hyper tension or hypercholesterolemia are more likely to receive antihyperte nsive medications and lipid-lowering agents than persons without diabe tes. Hypercholesterolemia is less likely to be controlled by lipid-low ering agents than hypertension in nondiabetic subjects, suggesting the need for further education of physicians and patients regarding the n eed for treating dyslipidemias.