Specialist in Family and Community Medicine, Colloto Health Clinic, Principality of Asturias Health Service, Asturias, Spain; Fundacion redGEDAPS, Spain.
Fundacion redGEDAPS, Spain; Specialist in Family and Community Medicine, Tafalla Health Center, Tafalla, Navarrese Health Service, Navarra, Spain.
Semergen. 2024 Sep;50(6):102220. doi: 10.1016/j.semerg.2024.102220. Epub 2024 Mar 29.
To determine the prevalence, impact and management of hypertension-mediated organ damage (HMOD) according to the presence of type 2 diabetes (T2DM).
IBERICAN is an ongoing multicenter, observational and prospective study, including outpatients aged 18-85 years who attended the Primary Care setting in Spain. In this study, the prevalence, impact and management of HMOD according to the presence of T2DM at baseline were analyzed.
At baseline, 8066 patients (20.2% T2DM, 28.6% HMOD) were analyzed. Among patients with T2DM, 31.7% had hypertension, 29.8% dyslipidemia and 29.4% obesity and 49.3% had ≥1 HMOD, mainly high pulse pressure (29.6%), albuminuria (16.2%) and moderate renal impairment (13.6%). The presence of T2DM significantly increased the risk of having CV risk factors and HMOD. Among T2DM population, patients with HMOD had more dyslipidemia (78.2% vs 70.5%; P=0.001), hypertension (75.4% vs 66.4%; P=0.001), any CV disease (39.6% vs 16.1%; P=0.001) and received more drugs. Despite the majority of types of glucose-lowering agents were more frequently taken by those patients with HMOD, compared to the total T2DM population, the use of SGLT2 inhibitors and GLP-1 receptor agonists was marginal.
In patients daily attended in primary care setting in Spain, one in five patients had T2DM and nearly half of these patients had HMOD. In patients with T2DM, the presence of HMOD was associated with a higher risk of CV risk factors and CV disease. Despite the very high CV risk, the use of glucose-lowering agents with proven CV benefit was markedly low.
根据是否患有 2 型糖尿病(T2DM),确定高血压介导的器官损伤(HMOD)的患病率、影响和管理情况。
IBERICAN 是一项正在进行的多中心、观察性和前瞻性研究,纳入了年龄在 18-85 岁之间、在西班牙初级保健机构就诊的门诊患者。在这项研究中,根据基线时是否患有 T2DM,分析了 HMOD 的患病率、影响和管理情况。
基线时,共分析了 8066 例患者(20.2%为 T2DM,28.6%有 HMOD)。在患有 T2DM 的患者中,31.7%患有高血压,29.8%患有血脂异常,29.4%患有肥胖症,49.3%有≥1 种 HMOD,主要为高脉压(29.6%)、蛋白尿(16.2%)和中度肾功能损害(13.6%)。T2DM 的存在显著增加了患有心血管危险因素和 HMOD 的风险。在 T2DM 人群中,有 HMOD 的患者血脂异常(78.2%比 70.5%;P=0.001)、高血压(75.4%比 66.4%;P=0.001)、任何心血管疾病(39.6%比 16.1%;P=0.001)的发生率更高,接受的药物也更多。尽管与 T2DM 总人群相比,有 HMOD 的患者更常服用大多数类型的降糖药物,但 SGLT2 抑制剂和 GLP-1 受体激动剂的使用率较低。
在西班牙初级保健机构日常就诊的患者中,每五例患者中就有一例患有 T2DM,其中近一半患者有 HMOD。在患有 T2DM 的患者中,HMOD 的存在与更高的心血管危险因素和心血管疾病风险相关。尽管心血管风险很高,但具有明确心血管获益的降糖药物的使用率明显较低。