Abstract
The literature about possible cardiovascular consequences of diagnostic inertia in diabetes is scarce. We examined the influence of undetected high fasting blood glucose (FBG) levels on the cardiovascular risk and poor control of cardiovascular risk factors in hypertensive or obese patients, with no previous diagnosis of diabetes mellitus (i.e., diagnostic inertia). A cross-sectional study during a preventive program in a Spanish region was performed in 2003–2004. The participants were aged ≥40 years and did not have diabetes but were hypertensive (n = 5, 347) or obese (n = 7, 833). The outcomes were high cardiovascular risk (SCORE ≥5%), poor control of the blood pressure (≥140/90 mmHg) and class II obesity. The relationship was examined between FBG and the main parameters, calculating the adjusted odd ratios with multivariate models. Higher values of FBG were associated with all the outcomes. A more proactive attitude towards the diagnosis of diabetes mellitus in the hypertensive and obese population should be adopted.
Highlights
Cardiovascular diseases (CVD) are the leading cause of mortality in the world (WHO, 2011)
Along with hypertension, dyslipidaemia, obesity and smoking, is one of the main risk factors for CVD (D’Agostino Sr et al, 2008). These risk factors are associated with each other; for instance, the chronic hyperglycaemia produced by diabetes is associated with high blood pressure (BP) and obesity (Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2003)
When we started this study we expected to find that our patients who had no previous diagnosis of diabetes would have a lower magnitude of altered fasting blood glucose (FBG) screening results and that this would not be associated with a greater cardiovascular risk, poor BP control or class II obesity. The results for this association were not expected, as all these patients attended their health centre regularly. At these visits to control their cardiovascular risk factors (CVRF), the physicians ought to order a blood test to control the lipid and FBG levels in order to discard the presence of dyslipidaemia and diabetes mellitus, respectively, as these CVRF usually coexist in patients with hypertension and obesity (Pedrera Carbonell et al, 2005)
Summary
Cardiovascular diseases (CVD) are the leading cause of mortality in the world (WHO, 2011). Along with hypertension, dyslipidaemia, obesity and smoking, is one of the main risk factors for CVD (D’Agostino Sr et al, 2008). A very recent systematic review (Lebeau et al, 2014) determined that this concept has been adapted to making mistakes in the diagnosis of a disorder (rather than its treatment), and is known as diagnostic inertia. This diagnostic inertia has already been assessed in both hypertension and in dyslipidaemia, determining both its prevalence and its association
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
