Difficulties in reaching therapeutic goals for hypertension and dysplipidaemia in patients with type 2 diabetes in general practice.

INTRODUCTION

National guidelines recommend strict control of blood pressure (BP) and plasma low-density lipoprotein cholesterol (LDL) in type 2 diabetes (T2DM), aiming at a BP ≤ 130/80 mmHg and an LDL concentration ≤ 2.5 mmol/l. Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II-receptor blockers (ARB) are recommended as primary antihypertensive therapy (AHT). To which extent these targets are met in Danish primary care is unknown.

MATERIAL AND METHODS

This study was based on data from 2,057 patients with T2DM who were randomly selected from 64 general practitioners (GPs) from different regions of Denmark. Data were collected from the GPs' electronic records.

RESULTS

The mean age ± standard deviation was 66.2 ± 11.6 years; 58.7% were male. The mean systolic BP ± standard deviation was 132.6 ± 14.6 mmHg and the mean diastolic BP ± standard deviation was 78.1 ± 9.0 mmHg. 47.7% of the patients met the BP target. 79.5% of the patients were on AHT. 55.1% of the untreated and 46.0% of the treated patients met the BP target. 83.4% of the treated patients received ACEI or ARB. The median LDL was 2.2 (1.7-2.7) mmol/l. 63.7% of the patients met the LDL target. 73.7% of the patients received lipid-lowering therapy. 32.8% of the untreated and 74.4% of the treated patients met the LDL target.

CONCLUSION

AHT including ACEI and ARB and lipid-lowering therapy are widely used in T2DM in Danish primary care, but only half of the patients are at target for BP and two thirds are at target for LDL. Increased use of diuretics may improve BP control.

FUNDING

This study was funded by a grant from Boehringer Ingelheim, Denmark. The grant covered costs related to data collection, time spent by the general practitioners and data analysis by the DTU.

TRIAL REGISTRATION

not relevant.