Prevalence and management of hypertension in Type 1 diabetes mellitus in Europe: the EURODIAB IDDM complications study

Aim. To examine the prevalence of hypertension and the rates of hypertensio n awareness by investigating treatment and control among respondents to the EURODIAB IDDM Complications Study, and to explore the variation in hyperte nsion management by age, sex and end-organ damage. Methods. A cross-sectional study, examining 3250 randomly selected Type I d iabetic patients from 31 diabetes clinics in 16 European countries between 1989 and 1990. Mean age was 32.7 years (SD = 10.0) and mean duration of dia betes mellitus (DM) was 14.7 years (SD = 9.3). Subjects were asked about a history of high blood pressure (BP) and current prescribed medications were recorded by the subject's physician. Hypertension was defined as having a systolic BP greater than or equal to 140 mmHg or diastolic BP greater than or equal to 900 mmHg or current use of antihypertensives. Control was defin ed as a BP < 130/85 mmHg. Results. Twenty-four per cent of subjects had hypertension, among whom fewe r than one-half (48.5%) were aware of a previous diagnosis and a similar pr oportion (42.2%) were on treatment. Only 11.3% of those with hypertension w ere both treated and controlled. The majority (81%) of those receiving drug therapy for hypertension were on a single drug, most commonly an angiotens in-converting enzyme inhibitor (47%). Conclusion. These data show the extent of undermanagement of hypertension i n Type I DM across Europe prior to the publication of the St. Vincent Decla ration and provide a useful baseline against which future improvements in t he management of hypertension can be monitored.