Behnoush Amir Hossein, Khosravi Sepehr, Ziamanesh Fateme, Atlasi Rasha, Sheidaei Ali, Sanadgol Negin, Khalaji Amirmohammad, Tabatabaei-Malazy Ozra, Ostovar Afshin
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Curr Diabetes Rev. 2024 Jul 31. doi: 10.2174/0115733998327293240729080250.
The control of blood pressure (BP) is a challenge in diabetic patients and is associated with adverse outcomes of diabetes. In this systematic review and metaanalysis, we investigated the BP control rate among hypertensive diabetic patients in the Eastern Mediterranean Region (EMR) countries.
We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases up to January 2023 for observational studies on BP control among hypertensive diabetic patients in all EMR countries. We included studies reporting the proportion of hypertensive, type 2 diabetic patients with controlled BP, defined as systolic/diastolic BP < 140/90 or <130/80 mmHg. Study quality was assessed using modified STROBE guidelines, and a random-effect meta-analysis was conducted to pool prevalence data and calculate overall rates. Subgroup analysis was performed by gender, study design, country, and BP control cut-offs (140/90 and 130/80).
Among the 1949 retrieved studies, 20 studies assessing 27956 individuals were included. The proportion of BP control regardless of cut-off points was 36.8% (95% CI=29.1%45.3%) based on the studies reported for both genders.The prevalence was 53.2% (95% CI=36.1%- 69.6%) and 43.5% (95% CI=20.0%-70.3%) based on the studies reported just for women or men, respectively.
Our findings indicate that BP control targets are not successfully achieved in hypertensive diabetic patients in the Eastern Mediterranean region. It is recommended to place greater emphasis on the quality of hypertension care in the management of type 2 diabetes.
血压控制是糖尿病患者面临的一项挑战，且与糖尿病的不良结局相关。在这项系统评价和荟萃分析中，我们调查了东地中海区域（EMR）国家高血压糖尿病患者的血压控制率。
我们系统检索了截至2023年1月的PubMed、Scopus、Embase、Cochrane和Web of Science数据库，以查找关于所有EMR国家高血压糖尿病患者血压控制的观察性研究。我们纳入了报告高血压2型糖尿病患者血压得到控制（定义为收缩压/舒张压<140/90或<130/80 mmHg）比例的研究。使用改良的STROBE指南评估研究质量，并进行随机效应荟萃分析以汇总患病率数据并计算总体率。按性别、研究设计、国家和血压控制临界值（140/90和130/80）进行亚组分析。
在检索到的1949项研究中，纳入了20项评估27956名个体的研究。根据两性报告的研究，无论临界值如何，血压控制比例为36.8%（95%CI=29.1%-45.3%）。仅根据女性或男性报告的研究，患病率分别为53.2%（95%CI=36.1%-69.6%）和43.5%（95%CI=20.0%-70.3%）。
我们的研究结果表明，东地中海地区高血压糖尿病患者未成功实现血压控制目标。建议在2型糖尿病管理中更加重视高血压护理质量。
