Background
Treatment of hypertension in patients with type 2 diabetes (T2DM) has always been a challenge. Hypertension is very prevalent (63%) among Emirati patients with T2DM and associated with several cardiovascular complications. Although systolic blood pressure (sBP) is a classic predicator of cardiovascular heart diseases, diastolic blood pressure (dBP) has recently received much attention and considered as a risk factor of myocardial infraction.
The present study aims (i) to determine the prevalence of diastolic hypotension (DH) in a cohort of T2DM patients with hypertension and (ii) to investigate the relationship, if any, between antihypertensive and T2DM therapies and dBP.
Methods
500 medical records of T2DM patients with hypertension have randomly been selected and screened (Rashid Centre for Diabetes and Research). The inclusion criteria were as follow: (i) patient with T2DM, (ii) Emirati patients and (iii) hypertensive patients. 82% of the medical records were reviewed and analyzed and the following variables were included in the investigation: anthropometric variables, diabetes duration, BMI, HbA1c, sBP, dBP, lipid profile, antihypertensive and anti-diabetic medications.
Results
The results of the present study have show that low dBP is experienced by 40% (dBP < 70 mmHg) of the T2DM hypertensive patients whereas well-documented diastolic hypotension has been reported in less number (10%) of participants. Another important factor has been significantly correlated to diastolic hypotension is age (p = 0.001). Comparing the effects of using different subtypes of medications on the dBP, it has been shown that metformin with sulfonylurea and angiotensin II receptor blockers (ARBs) have more pronounced effects on dBP (p = 0.05). Metformin in combination with other subtypes of antidiabetic medications and different antihypertensive therapies had less effect on dBP.
Conclusion
Diastolic hypotension seems to be associated with use of sulfonylurea and ARBs in hypertensive Emirati patients with T2DM.