PREVALENCE OF ARTERIAL-HYPERTENSION IN DIABETIC-PATIENTS BEFORE AND AFTER THE JNC-V

OBJECTIVE - To compare the prevalence of arterial hypertension in pati ents with insulin-dependent diabetes mellitus (IDDM) and non-insulin-d ependent diabetes mellitus (NIDDM) according to blood pressure (BP) cr iteria from the World Health Organization (WHO) and The Fifth Report o f the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V). RESEARCH DESIGN AND METHODS- Two cohor ts of Caucasian patients attending the outpatient clinic al Hvidore Ho spital were identified: 1) 957 patients with IDDM; 53% men, 40 (18-75) years of age (mean [range]), and 2) 549 patients with NIDDM; 53% men, 60 (20-76) years of age. BP was measured at least yearly, while patie nts rested in a sitting position, with a standard clinical sphygmomano meter. Patients were classified as hyper- or normotensive based on ave rage BP during a 3-year follow-up period. Patients receiving antihyper tensive treatment were classified as hypertensives. RESULTS - In IDDM patients, the prevalence of arterial hypertension rose from 15 to 42% in the normoalbuminuric group, from 26 to 52% in the microalbuminuric group, and from 61 to 79% in the macroalbuminuric group when WHO and J NC-V criteria were compared. The corresponding rises in NIDDM patients were from 51 to 71% (normo-), from 73 to 90% (micro-), and from 82 to 93% (macroalbuminuria). Of the untreated hypertensive patients, 78% o f IDDM patients and 50% of NIDDM patients had stage 1 (140-159/90-99 m mHg) hypertension; 20% of IDDM patients and 37% of NIDDM patients had stage 2 (160-179/100-109 mmHg) hypertension. Two out of three untreate d hypertensive patients had isolated systolic hypertension. CONCLUSION S - The new JNC-V criteria approved by the American Diabetes Associati on leads to a considerable increase in the prevalence of arterial hype rtension in a population of IDDM and NIDDM patients. Isolated systolic hypertension contributes importantly.