Prevalence, impact and management of hypertension-mediated organ damage in type 2 diabetes patients

  1. Anny Romero Secín
  2. Javier Díez Espino
  3. Vicente Pallarés Carratalá
  4. Alfonso Barquilla García
  5. R. Mico Pérez
  6. José Polo García
  7. S. M. Velilla- Zancada
  8. Vicente Martín Sánchez
  9. Antonio Segura Fragoso
  10. Leovigildo Ginel Mendoza
  11. Víctor M. Arce Vázquez
  12. Sergio Cinza Sanjurjo
Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Ano de publicación: 2024

Número: 6

Tipo: Artigo

DOI: 10.1016/J.SEMERG.2024.102220 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Semergen: revista española de medicina de familia

Resumo

Objective To determine the prevalence, impact and management of hypertension-mediated organ damage (HMOD) according to the presence of type 2 diabetes (T2DM). Methods IBERICAN is an ongoing multicenter, observational and prospective study, including outpatients aged 18–85 years who attended the Primary Care setting in Spain. In this study, the prevalence, impact and management of HMOD according to the presence of T2DM at baseline were analyzed. Results At baseline, 8066 patients (20.2% T2DM, 28.6% HMOD) were analyzed. Among patients with T2DM, 31.7% had hypertension, 29.8% dyslipidemia and 29.4% obesity and 49.3% had ≥1 HMOD, mainly high pulse pressure (29.6%), albuminuria (16.2%) and moderate renal impairment (13.6%). The presence of T2DM significantly increased the risk of having CV risk factors and HMOD. Among T2DM population, patients with HMOD had more dyslipidemia (78.2% vs 70.5%; P = 0.001), hypertension (75.4% vs 66.4%; P = 0.001), any CV disease (39.6% vs 16.1%; P = 0.001) and received more drugs. Despite the majority of types of glucose-lowering agents were more frequently taken by those patients with HMOD, compared to the total T2DM population, the use of SGLT2 inhibitors and GLP-1 receptor agonists was marginal. Conclusions In patients daily attended in primary care setting in Spain, one in five patients had T2DM and nearly half of these patients had HMOD. In patients with T2DM, the presence of HMOD was associated with a higher risk of CV risk factors and CV disease. Despite the very high CV risk, the use of glucose-lowering agents with proven CV benefit was markedly low.

Referencias bibliográficas

  • F. Soriguer, A. Goday, A. Bosch-Comas, E. Bordiú, A. Calle-Pascual, R. Carmena, et al. Prevalence of diabetes mellitus and impaired glucose regulation in Spain: the Di@bet.es study Diabetologia, 55 (2012), pp. 88-93
  • International Diabetes Federation. IDF diabetes atlas—10th edition. Brussels: International Diabetes Federation; 2021. Available from: https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf.
  • N. Sarwar, P. Gao, S.R. Seshasai, R. Gobin, S. Kaptoge, E. Di Angelantonio, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet, 375 (2010), pp. 2215-2222
  • N. Marx, M. Federici, K. Schütt, D. Müller-Wieland, R.A. Ajjan, M.J. Antunes, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J, 44 (2023), pp. 4043-4140
  • N.A. ElSayed, G. Aleppo, V.R. Aroda, R.R. Bannuru, F.M. Brown, D. Bruemmer, et al. Cardiovascular disease and risk management: standards of care in diabetes-2023. Diabetes Care, 46 (Suppl. 1) (2023), pp. S158-S190
  • E. Martín-Rioboó, C. Brotons-Cuixart, A. Ruiz García, F. Villafañe Sanz, M. Frías Vargas, A. Moyá Amengual, et al. Lights and shadows of the 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Rev Esp Salud Publica, 97 (2023), p. e202308064
  • C.S. Fox, K. Matsushita, M. Woodward, H.J. Bilo, J. Chalmers, H.J.L. Heerspink, et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet, 380 (2012), pp. 1662-1673
  • J.R. Brownrigg, C.O. Hughes, D. Burleigh, A. Karthikesalingam, B.O. Patterson, P.J. Holt, et al. Microvascular disease and risk of cardiovascular events among individuals with type 2 diabetes: a population-level cohort study. Lancet Diabetes Endocrinol, 4 (2016), pp. 588-597
  • Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int 2022; 102(Suppl. 5S):S1–S127.
  • S. Cinza Sanjurjo, J.L. Llisterri Caro, A. Barquilla García, J. Polo García, S. Velilla Zancada, G.C. Rodríguez Roca, et al. Description of the sample, design and methods of the study for the identification of the Spanish population at cardiovascular and renal risk (IBERICAN). Semergen, 46 (2020), pp. 4-15
  • S. Cinza-Sanjurjo, R.M. Micó-Pérez, S. Velilla-Zancada, M.A. Prieto-Díaz, G.C. Rodríguez-Roca, A. Barquilla García, et al. Factors associated with cardiovascular risk and cardiovascular and renal disease in the IBERICAN study: final results. Semergen, 46 (2020), pp. 368-378
  • J.L. Llisterri, R.M. Micó-Pérez, S. Velilla-Zancada, G.C. Rodríguez-Roca, Prieto-Díaz MÁ, V. Martín-Sánchez, et al. Prevalence of chronic kidney disease and associated factors in the Spanish population attended in primary care: results of the IBERICAN study. Med Clin (Barc), 156 (2021), pp. 157-165
  • I.M. Peral Martínez, A. Martínez Pastor, J.J. Gomariz García, A. Barquilla García, V. Martín Sánchez, R. Micó Pérez, et al. Regional differences in the degree of glycaemic diabetes control in Spain and associated factors. IBERICAN study. Endocrinol Diabetes Nutr (Engl Ed), 70 (2023), pp. 448-458
  • Moyá-Amengual, A. Ruiz-García, V. Pallarés-Carratalá, A. Serrano-Cumplido, M.Á. Prieto-Díaz, A. Segura-Fragoso, et al. Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study. Front Cardiovasc Med, 10 (2023), p. 1090458
  • G. Mancia, R. Fagard, K. Narkiewicz, J. Redón, A. Zanchetti, M. Böhm, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens, 31 (2013), pp. 1281-1357
  • F. Cosentino, P. Grant, V. Aboyans, C. Bailey, A. Ceriello, V. Delgado, et al. 2019 Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD. Eur Heart J, 41 (2020), pp. 255-323
  • V. Gil-Guillen, D. Orozco-Beltran, J. Redon, S. Pita-Fernandez, J. Navarro-Pérez, V. Pallares, et al. Rationale and methods of the cardiometabolic Valencian study (Escarval-Risk) for validation of risk scales in Mediterranean patients with hypertension, diabetes or dyslipidemia. BMC Public Health, 10 (2010), p. 717
  • M. Grau, R. Elosua, A. Cabrera de León, M.J. Guembe, J.M. Baena-Díez, T. Vega Alonso, et al. Cardiovascular risk factors in Spain in the first decade of the 21st Century, a pooled analysis with individual data from 11 population-based studies: the DARIOS study. Rev Esp Cardiol, 64 (2011), pp. 295-304
  • Graciani, L.M. León-Muñoz, P. Guallar-Castillón, F. Rodríguez Artalejo, J.R. Banegas. Cardiovascular health in a southern Mediterranean European country: a nationwide population based study. Circ Cardiovasc Qual Outcomes, 6 (2013), pp. 90-98
  • J. Marrugat, I. Subirana, R. Ramos, J. Vila, A. Marín-Ibañez, M.J. Guembe, et al. Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: the FRESCO study. Prev Med, 61 (2014), pp. 66-74
  • J. Cosín-Sales, R. Campuzano Ruiz, J.L. Díaz Díaz, C. Escobar Cervantes, M.R. Fernández Olmo, J.J. Gómez-Doblas, et al. Impact of physician's perception about LDL cholesterol control in clinical practice when treating patients in Spain. Atherosclerosis, 375 (2023), pp. 38-44
  • J.R. Banegas. El Proyecto IBERICAN. The IBERICAN Project. Progressing in the knowledge of cardiovascular risk in primary care in Spain. Semergen, 46 (2020), pp. 1-3
  • S. Eder, J. Leierer, J. Kerschbaum, L. Rosivall, A. Wiecek, D. de Zeeuw, et al. A prospective cohort study in patients with type 2 diabetes mellitus for validation of biomarkers (PROVALID) – study design and baseline characteristics. Kidney Blood Press Res, 43 (2018), pp. 181-190
  • K. Zatońska, A. Basiak-Rasała, D. Różańska, M. Karczewski, M. Wołyniec, A. Szuba, et al. Changes in diabetes prevalence and corresponding risk factors – findings from 3- and 6-year follow-up of PURE Poland cohort study. BMC Public Health, 20 (2020), p. 843
  • J. Teck. Diabetes-associated comorbidities. Prim Care, 49 (2022), pp. 275-286
  • V. Tsimihodimos, C. Gonzalez-Villalpando, J.B. Meigs, E. Ferrannini. Hypertension and diabetes mellitus: coprediction and time trajectories. Hypertension, 71 (2018), pp. 422-428
  • G. Mancia, R. Kreutz, M. Brunström, M. Burnier, G. Grassi, A. Januszewicz, et al. 2023 ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens (2023), 10.1097/HJH.0000000000003480
  • H. Alemi, P. Khaloo, M.A. Mansournia, S. Rabizadeh, S.S. Salehi, H. Mirmiranpour, et al. Pulse pressure and diabetes treatments: Blood pressure and pulse pressure difference among glucose lowering modality groups in type 2 diabetes. Medicine (Baltimore), 97 (2018), p. e9791
  • J.R. Cockcroft, I.B. Wilkinson, M. Evans, P. McEwan, J.R. Peters, S. Davies, et al. Pulse pressure predicts cardiovascular risk in patients with type 2 diabetes mellitus. Am J Hypertens, 18 (2005), pp. 1463-1467
  • SCORE2-Diabetes Working Group and the ESC Cardiovascular Risk Collaboration. SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe. Eur Heart J. 2023;44:2544–56.
  • C. George, J.B. Echouffo-Tcheugui, B.G. Jaar, I.G. Okpechi, A.P. Kengne. The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low- and middle-income countries-a review of the current literatura. BMC Med, 20 (2022), p. 247
  • J. Lv, Y. Liu, Y. Yan, D. Sun, L. Fan, Y. Guo, et al. Relationship between left ventricular hypertrophy and diabetes is likely bidirectional: a temporality analysis. J Am Heart Assoc, 12 (2023), p. e028219
  • M. Moroney, R. Verma, M. Hibino, C.D. Mazer, K.A. Connelly, A.T. Yan, et al. Impact of diabetes duration on left ventricular mass regression with empagliflozin. ESC Heart Fail, 10 (2023), pp. 2134-2140
  • F. Nie, J. He, H. Cao, X. Hu. Predictive value of abnormal ankle-brachial index in patients with diabetes: a meta-analysis. Diabetes Res Clin Pract, 174 (2021), p. 108723
  • A.M. Cebrián-Cuenca, M. Mata-Cases, J. Franch-Nadal, D. Mauricio, D. Orozco-Beltrán, L. Consuegra-Sánchez. Half of patients with type 2 diabetes mellitus are at very high CV risk according to the ESC/EASD: data from a large Mediterranean population. Eur J Prev Cardiol, 28 (2022), pp. e32-e34
  • J.D. Spence, L. Pilote. Importance of sex and gender in atherosclerosis and CV disease Atherosclerosis, 241 (2015), pp. 208-210
  • N.A. ElSayed, G. Aleppo, V.R. Aroda, R.R. Bannuru, F.M. Brown, D. Bruemmer, et al. Pharmacologic approaches to glycemic treatment: standards of care in diabetes-2023. Diabetes Care, 46 (Suppl. 1) (2023), pp. S140-S157
  • D.K. McGuire, W.J. Shih, F. Cosentino, B. Charbonnel, D.Z. Cherney, S. Dagogo-Jack, et al. Association of SGLT2 inhibitors with CV and kidney outcomes in patients with type 2 diabetes: a meta-analysis. JAMA Cardiol, 6 (2021), pp. 148-158
  • N. Sattar, M.M. Lee, S.L. Kristensen, K.R. Branch, S. Del Prato, N.S. Khurmi, et al. CV, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. Lancet Diabetes Endocrinol, 9 (2021), pp. 653-662
  • C. Escobar, V. Barrios, J. Cosín, J.M. Gámez Martínez, A.I. Huelmos Rodrigo, C. Ortíz Cortés, et al. SGLT2 inhibitors and GLP1 agonists administered without metformin compared to other glucose-lowering drugs in patients with type 2 diabetes mellitus to prevent cardiovascular events: a systematic review. Diabetes Med, 38 (2021), p. e14502
Fonte de datos: Dialnet