Risk factor clustering in patients with hypertension and non-insulin-dependent diabetes mellitus.: The Skaraborg Hypertension Project

Objectives. To assess the coexistence of hypertension and diabetes, associations with cardiovascular risk factors and the achievement of current treatment goals. Design. A community-based, cross-sectional, observational study. Setting. Hypertension and diabetes outpatient clinics in primary health care, Skara, Sweden. Subjects. All patients (n = 1116; 488 men, 628 women) who performed an annual follow-up from May 1992 to September 1993. Main outcome measures, Hypertension, non-insulin-dependent diabetes mellitus (NIDDM), blood pressure, fasting B-glucose, lipids, HbAlc, body mass index (BMI), waist hip ratio (WHR). Results, Hypertension alone was found in 286 men and 430 women, hypertension and NIDDM combined in 102 men and 102 women, and NIDDM alone in 100 men and 96 women. Taking new cases into account, the proportion of hypertension among NIDDM patients was 57%, and the proportion of NIDDM among hypertensives was 26%. Men and women with both hypertension and NIDDM had a higher systolic blood pressure and women also had a higher diastolic blood pressure (men 168/88 mmHg, women 165/86 mmHg) than those with hypertension alone (men 152/87 mmHg, women 156/82 mmHg) (P less than or equal to 0.001). Cardiovascular risk factors accumulated in patients with both hypertension and NIDDM. (triglycerides, BMI and WHR). A diastolic blood pressure less than or equal to 90 mmHg was achieved by 71% men and 84% women with hypertension. HbAlc <7.5% was attained by 71% men and 70% women with NIDDM. Conclusions. A considerable coexistence of hypertension and NIDDM was demonstrated. Cardiovascular risk factors clustered in patients with both diseases and their blood pressure was less controlled. These patients thus comprised a clinically defined group at high risk. By current guidelines, control of hypertension and NIDDM seemed appropriate.