Disturbingly low success in the control of hypertension in diabetics in the Czech Republic

Overview

Aims:
Hypertension in diabetic subjects is a common condition, leading to a substantially increased risk of cardiovascular disease. Hypertension control in diabetics considerably improves their prognosis. The present paper focuses on the prevalence, awareness, treatment and control in subjects with diabetes in the Czech population.

Methods:
A random sample of 6380 persons 45–69 years old in seven Czech towns was investigated in a cross-sectional survey. Participants completed a questionnaire and underwent a short examination, including the measuring of blood pressure. The presence of diabetes diagnosed by a doctor was established through a questionnaire. Hypertension was defined as blood pressure ≥140/90 mm Hg or antihypertensive treatment. We used two recommended target values for hypertension control: <140/90 mm Hg (recommended for the general population) and <130/80 mm Hg (recommended for diabetics).

Results:
There were 731 subjects with diabetes and 5649 non-diabetics (prevalence of diabetes 12 %). The prevalence of hypertension in diabetics was 85 % (compared with 64 % in non-diabetic subjects); 96 % of diabetics had blood pressure ≥130/80 mm Hg. Among hypertensive diabetics, 81 % were aware of their hypertension, 73 % was treated and 20 % were controlled. Among diabetics with blood pressure ≥130/80 mm Hg or on antihypertensive treatment, the target value of <130/80 mm Hg was achieved in 7 % of subjects (10 % of treated). Treatment and control of hypertension were more common in females than in males. The results were similar in diabetics who were and were not treated with insulin.

Conclusions:
The control of hypertension in subjects with diabetes in the Czech population is disturbingly low despite relatively high rates of awareness. To improve this situation, it is necessary to implement the existing recommendations, particularly knowledge of target blood pressure values and aggressive treatment with effective drugs and their combinations.