The Prevalence of Resistant Hypertension Among Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology, and Genetics

Abstract

Background: In type 2 diabetic patients, resistant hypertension (RH) is associated with higher cardiovascular diseases (CVDs) and renal diseases; however, a prevalence of RH in the Middle East is unknown. Long duration of uncontrolled blood pressure and diabetes may increase the risk of RH. This study aimed to assess the prevalence of hypertension and RH among adult type 2 diabetic patients, and to determine the relationship between RH and patient demographics. Methods: A cross-sectional study was conducted from December 25, 2015 to the end of January 2016 at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG) in Amman, Jordan. A total of 1,106 type 2 diabetic patients were recruited. Data were obtained directly from the patients and patient medical file using a pre-prepared data collection sheet. Patients were considered to be hypertensive according to the physician’s diagnosis on patient medical files, and hypertensive patients were considered to have RH if systolic blood pressure was ? 140 mm Hg and/or diastolic blood pressure was ? 90 mm Hg even using three antihypertensive medications or patients who had blood pressure < 140/90 mm Hg but using four medications or more. Chi-square test was used to compare categorical differences, and logistic regression was used to calculate the adjusted odds ratio. Results: In the study subjects, 53% were females. The mean age was 60 ± 10.41 years (mean ± SD), 66% had poor glycemic control, 47% had long-standing diabetes for 10 years or more, and 93% were obese and overweight. The overall prevalence of hypertension was 79.6% (n = 880), and the prevalence of RH was 12% among type 2 diabetic patients and 16% among diabetic hypertensive patients (n = 141). Logistic regression analysis revealed that increasing age, obesity, long-standing hypertension, hypertension controlling, and CVDs were significantly correlated with RH. Conclusion: The prevalence of RH, among adult type 2 diabetic patients, was 16%; older age, obesity, long duration and poor blood pressure control and CVD were significantly and positively associated with RH. RH is a serious problem which could worsen complications due to diabetes and hypertension, thus increased awareness is needed for patients and medical team about RH and its risk factors. J Endocrinol Metab. 2017;7(5):153-158 doi: https://doi.org/10.14740/jem448e