BLOOD PRESSURE CONTROL IN DIABETIC SUBJECTS: A NATIONWIDE EPIDEMIOLOGICAL SURVEY AMONG ITALIAN PHARMACIES CUSTOMERS

Abstract

Abstract Objective: The prevalence of hypertension is estimated at around 30% of the adult population in industrialized countries and is much higher in patients with diabetes mellitus. The global percentage of hypertensive individuals whose condition is treated and controlled is currently low. We analyzed data from a nationwide, cross-sectional epidemiological survey on pharmacies customers in order to have an overview of the prevalence and awareness of cardiovascular (CV) risk factors, with particular focus on hypertension and diabetes. Design and method: The survey was conducted in 3956 Italian pharmacies from 17 to 20 May 2018. Self-presenting participants were asked to answer a questionnaire on their clinical and demographic characteristics and lifestyle habits, and trained pharmacists measured their blood pressure (BP) according to guidelines. Prevalence of CV risk factors and hypertension rate/control according to the latest version of the European guidelines on hypertension was examined by diabetic status. Statistical analyses were performed using R (v3.5.1). Results: A total of 47217 subjects were enrolled in the project: 5695 diabetics and 41522 non-diabetics. Their characteristics are shown in Table 1. Compared to non-diabetic patients, those with diabetes tended to be older, to declare a family/personal history of CV diseases/chronic kidney disease, to have prevalent/uncontrolled hypertension, dyslipidemia, higher mean systolic BP (135,96 ± 18,38 mmHg vs 128,32 ± 17,77 mmHg), and greater CV risk (p < 0.001). No significant differences in terms of salt intake, vegetable consumption, and smoking habits were recorded between the examined groups. Diabetic subjects with uncontrolled hypertension showed a lower propensity to physical activity (p = 0.016). Conclusions: Despite the limitations of the study design (selection bias, self-reported information, no data on medications and compliance, lack of generalizability), our results are substantially in line with the available literature, underlining that BP control is more challenging in diabetic patients, who normally present with a higher global CV risk. As lifestyle interventions (including dietary changes, weight loss, increased physical activity) appear effective both in lowering BP and reducing the incidence of diabetes, similar awareness-rising campaigns might be useful to promote CV health.