Abstract

Objective: The aim of the study was to analyse the risk profile of patients with type 2 diabetes (T2D) and primary hypertension (AH) in a cohort of patients treated in Bulgarian General Practitioners’ practices. Design and method: A retrospective study of patients’ recordings in Bulgarian GPs’ practices was conducted in 2016. We were analysed the data from electronic health records of 142827 persons aged >18 years, and found 15933 patients with T2D and 45393 patients with high blood pressure or treated for AH. The patients with T2D and AH were selected and we were analysed the risk profile of 5926 consecutive patients aged >40 years (blood pressure, heart rate, lipid parameters, blood glucose levels and HbA1c, kidney function), known comorbidities, control of the blood pressure and of the lipid parameters, the use of cardioprotective therapy. The study was initiated and conducted by the National Association of General Practitioners in Bulgaria (NAGPB). Results: The prevalence of AH in the population >18 years of age was 31.8%. The prevalence of T2D was 7.0%. The mean blood pressure among 5926 patients aged >40 years was 137.7/86 mmHg and the heart rate - 74.5 beats/minute. The mean fasting blood glucose was 7.42 mmol/L, the mean HbA1c - 7.54%, the mean total cholesterol - 5.4 mmol/L, the mean triglycerides - 2.06 mmol/L, the mean LDL-cholesterol - 3.2 mmol/L (calculated according to Friedewald formula), the mean HDL-cholesterol - 1.34 mmol/L. The mean eGFR in men was 93.27 mL/min/1.73m2, and in women - 73.06 mL/min/1.73m2. 63.59% of the patient had blood pressure <140/85 mmHg. The blood pressure of the patients with HbA1c <7% was 133.6 /85.3 mmHg with heart rate 73.8 beats/minute, and in those with HbA1c >7% the mean blood pressure was 145.6 /84.3 mmHg and heart rate - 75.7 beats/minute. Conclusions: The blood pressure and glycemic control among the patients with T2D and hypertension is good, but further activities for improvement of the lipid risk in high and very high risk population are mandatory. The bad glycemic control is associated with worse blood pressure control.

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