CHARACTERISTICS OF THE HIGH BLOOD PRESSURE IN A TYPE 2 DIABETIC POPULATION IN THE AREA OF BLIDA (ALGERIA)

Abstract

Objective: The association diabetes-high blood pressure (BP) is frequent. It increases the cardiovascular risk and accelerates the onset of degenerative complications of diabetes. The aim of the present study was to test the effect of the hypertension-diabetes association on the degenerative complications of diabetes and to determine the proportion and the factors associated with uncontrolled hypertension. Design and method: This was a cross-sectional study conducted among 2129 type 2 diabetic hypertensive patients aged 40 years or over, followed in the internal medicine department of hospital of Blida (Algeria), between February 2020 to November 2022. Results: The average age was 46 ± 6.6 years, with a female predominance (73.5%). Hypertension was present in 60.4% of normal weight patients, in 55.1% of overweight patients and 62.8% of obese patients with a significant difference (p = 0.03). Macroangiopathy was observed in 57% of patients with mainly ischemic heart disease (44%). It was significantly more frequent in patients with LDL-c greater than 1.3 g/l and hypoHDLemia less than 0.35 g/l. The proportion of uncontrolled hypertension (BP > 140/90) was 55% including 13% of cases of severe hypertension (BP > 180/110). Resistant hypertension was found in 21% of cases. This poor blood pressure control was correlated with insulin treatment (p = 0.05), insufficient physical activity (p = 0.03), treatment duration greater than 10 years (p = 0.01) and a number of tablets greater than 2 (p = 0.031). We did not find a significant difference between the level of BP control and the seniority of diabetes, the body mass index, the presence of degenerative complications, the intellectual and socioeconomic level. The analytical study showed no positive association between the onset of hypertension and the following factors: the HbA1c level and the duration of diabetes progression. We found a strong correlation between the degenerative complications of diabetes and the presence of hypertension: retinopathy (p = 0.05), neuropathy (p = 0.02), nephropathy (p = 0.001), coronary artery disease (p = 0.001), cerebrovascular accidents (p = 0.01). Conclusions: Our study highlights the positive effect of hypertension on the degenerative complications of diabetes. Optimal control of blood pressure figures is imperative to limit the development of these complications and improve life expectancy.