1. ¹Department of Endocrinology, Hospital General de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
2. ²Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain
3. ³Department of Endocrinology, Hospital Obispo Polanco, Teruel, Spain
4. ⁴Department of Medicine, Abbott Laboratories, Madrid, Spain

Correspondence: Dr P de Pablos-Velasco, Department of Endocrinology, Hospital General de Gran Canaria Doctor Negrín, Las Palmas de Gran 35011 Canaria, Spain. E-mail: ppabvel@gobiernodecanarias.org; Dr A Khanbhai, Department of Medicine, Abbott Laboratories, Avenida de Burgos 91, Madrid 28050, Spain. E-mail: azminakhanbhai@yahoo.com

Received 30 December 2006; Revised 23 March 2007; Accepted 24 March 2007; Published online 26 April 2007.

Abstract

Numerous population studies confirm the high prevalence of hypertension in type II diabetic (DM2) subjects and that intensive antihypertensive treatment is more beneficial to diabetic than to nondiabetic hypertensive subjects, yet not many of these are specific to Spain. To assess the degree of blood pressure (BP) control and the effects of antihypertensive drugs in the medical management of hypertension in diabetic patients in specialist care centres throughout Spain, we studied the socio-demographic, clinical and relevant laboratory parameters of 796 hypertensive patients with DM2 (mean age 66.09 (95% confidence interval (CI): 64.08–68.10). The percentage of diabetic patients responding positively to BP control measures was lower when compared to the nondiabetic population in both Spain and Europe. The degree of control was poorer for systolic than for diastolic BP, yet 40.6% of the patients were only on monotherapy. The fact that antihypertensive treatment was modified in only 40% of the poorly controlled patients was also highly significant and could be attributed to a nonstringent use of clinical guidelines. Among the other differences between well-controlled and poorly controlled patients, we found that well-controlled patients presented with lower levels of cholesterol and triglycerides, a lower prevalence of excess weight/obesity, and a greater prevalence of cardiovascular and/or cerebrovascular disease despite having a greater percentage of patients on antiplatelet therapy. Better application of therapeutic guidelines and the prevention and treatment of compounding factors could improve the response rate to BP control measures in poorly controlled patients.