RISK FACTOR CLUSTERING IN PATIENTS WITH HYPERTENSION AND NON-INSULIN-DEPENDENT DIABETES-MELLITUS - THE SKARABORG-HYPERTENSION-PROJECT

Objectives. To assess the coexistence of hypertension and diabetes, as sociations with cardiovascular risk factors and the achievement of cur rent treatment goals. Design. A community-based, cross-sectional, obse rvational study. Setting. Hypertension and diabetes outpatient clinics in primary health care, Skara, Sweden. Subjects. All patients (n = 11 16; 488 men, 628 women) who performed an annual follow-up from May 199 2 to September 1993. Main outcome measures, Hypertension, non-insulin- dependent diabetes mellitus (NIDDM), blood pressure, fasting B-glucose , lipids, HbAlc, body mass index (BMI), waist hip ratio (WHR). Results , Hypertension alone was found in 286 men and 430 women, hypertension and NIDDM combined in 102 men and 102 women, and NIDDM alone in 100 me n and 96 women. Taking new cases into account, the proportion of hyper tension among NIDDM patients was 57%, and the proportion of NIDDM amon g hypertensives was 26%. Men and women with both hypertension and NIDD M had a higher systolic blood pressure and women also had a higher dia stolic blood pressure (men 168/88 mmHg, women 165/86 mmHg) than those with hypertension alone (men 152/87 mmHg, women 156/82 mmHg) (P less t han or equal to 0.001). Cardiovascular risk factors accumulated in pat ients with both hypertension and NIDDM. (triglycerides, BMI and WHR). A diastolic blood pressure less than or equal to 90 mmHg was achieved by 71% men and 84% women with hypertension. HbAlc <7.5% was attained b y 71% men and 70% women with NIDDM. Conclusions. A considerable coexis tence of hypertension and NIDDM was demonstrated. Cardiovascular risk factors clustered in patients with both diseases and their blood press ure was less controlled. These patients thus comprised a clinically de fined group at high risk. By current guidelines, control of hypertensi on and NIDDM seemed appropriate.