HYPERTENSION IN DIABETES STUDY (HDS) .1. PREVALENCE OF HYPERTENSION IN NEWLY PRESENTING TYPE-2 DIABETIC-PATIENTS AND THE ASSOCIATION WITH RISK-FACTORS FOR CARDIOVASCULAR AND DIABETIC COMPLICATIONS

Objective: To determine the prevalence of hypertension in newly diagno sed type 2 diabetic patients and its association with risk factors for cardiovascular and diabetic complications. Design: Cross-sectional st udy. Patients: Newly diagnosed type 2 diabetic patients (n = 3648, mea n age 52 years, 59% male) recruited for the UK Prospective Diabetes St udy (UKPDS). Measurements: Blood pressure, body mass index, waist:hip ratio, ECG signs of ischaemia and of left ventricular hypertrophy (Min nesota code), fasting plasma glucose, urate, creatinine, insulin, trig lycerides, high-density lipoprotein-, low-density lipoprotein- and tot al cholesterol, urinary albumin: creatinine ratio, retinopathy grading . Results: Thirty-nine per cent of the patients (35% of the males, 46% of the females) were hypertensive (mean blood pressure greater-than-o r-equal-to 160 systolic and/or greater-than-or-equal-to 90 mmHg diasto lic 2 and 9 months after diagnosis of diabetes, or taking antihyperten sive therapy). The hypertensive patients had a greater mean body mass index (30.1 versus 28.0 kg/m2, P < 0.0001) than the normotensive patie nts. They also had higher fasting plasma triglyceride (1.94 versus 1.6 9 mmol/l, P < 0.0001) and insulin (15.0 versus 12.8 mU/l, P < 0.0001) levels but these associations disappeared or weakened when obesity was taken into account. Hypertensive compared with normotensive subjects suffered a higher prevalence of cardiovascular events before the diagn osis of diabetes (4.8 versus 2.5%, P < 0.0001), of microalbuminuria (a lbumin: creatinine ratio > 5.0 g/mol; 24 versus 14%, P < 0.0001), of E CG signs of probable and possible ischaemia (24 versus 14%, P < 0.0001 ) and of left ventricular hypertrophy (8.5 versus 3.8%; P < 0.0001). T he prevalence of retinopathy was similar in the two groups. Conclusion s: Hypertension is common in newly diagnosed type 2 diabetes and is as sociated with obesity. The association between hypertension and higher triglyceride and insulin levels may be secondary to obesity in this p opulation. An association between hypertension and cardiovascular comp lications is already apparent at diagnosis of diabetes.