Research Article: Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China

Date Published: February 13, 2017

Publisher: Public Library of Science

Author(s): Xiao-bo Huang, Wei-wei Tang, Ya Liu, Rong Hu, Ling-yun Ouyang, Jian-xiong Liu, Xiu-jun Li, Yan-jing Yi, Tzung-Dau Wang, Shui-ping Zhao, Emilio Russo.

http://doi.org/10.1371/journal.pone.0170250

Abstract

This study aimed to assess the prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a cross-sectional survey was conducted in 4021 hypertensive patients aged 40 to 79 years living in Chengdu and Chongqing, China. Fasting plasma glucose (FPG) and 2h plasma glucose (2-hPG) in an oral glucose-tolerance test (OGTT) were used for assessments. Whether the patients previously had diabetes (DM) was determined by their own reports. The survey was carried out by the same questionnaire for all respondents. DM prevalence was 32.0% in hypertensive patients aged 40 to 79 years in Southwest China, with the rates of 29.6% and 33.5% in men and women, respectively (P<0.001). DM prevalence increased with age age and body-mass index. DM prevalence rates were 16.9%, 24.7%, 38.2% and 41.9% in hypertensive patients aged 40–49, 50–59, 60–69 and over 70, respectively. DM prevalence were 30.6%, 27.9%, 37.1%, and 37.4%, for BMI<18.5, 18.5–24.9, 25.0–29.9, and ≥30, respectively. Prevalence of unrecognized DM were 20.8% in hypertensive patients aged 40 to 79 years in Southwest China. Using only fasting blood glucose testing without OGTT would have resulted in 65.0% of missed DM diagnosis in these newly diagnosed patients. The prevalence of DM and unrecognized DM were high in hypertensive patients aged 40 to 79 years in Southwest China.These findings indicate that hypertensive patients aged 40 to 79 years should regularly submit to community-based OGTT screening for timely DM diagnosis.

Partial Text

Hypertension is a common chronic disease, and a major risk factor for cardiovascular diseases. It greatly increases the risk of stroke, myocardial infarction, heart failure, and chronic kidney disease[1]. In China, the prevalence of hypertension in adults over 20 years of age is 26.6%, with about 250 million individuals suffering from high blood pressure [2]. As another risk factor for cardiovascular diseases, DM is highly prevalent in China. Indeed, 9.7% of adults over 20 years have DM, i.e. 92 million Chinese [3]. Cardiovascular disease prevention and control faces huge challenges. If hypertensive patients also have DM, the occurrence and development of atherosclerosis might be accelerated. Specifically, the risk of cardiovascular diseases in hypertensive patients with DM is at least twice than patients only suffering from hypertension [4]. In addition, it is harder to control blood pressure in hypertensive patients with DM than those without DM. Three antihypertensive drugs are often needed for hypertensive patients with DM [5]. Thus, early diagnosis and intervention of DM in hypertensive patients are of great significance.

From 2013 to 2014, a cross-sectional survey was carried out in hypertensive populations aged 40 to 79 years in two cities of China, Chengdu and Chongqing, and the investigation found DM prevalence was 32.0%. These findings suggested that approximately one-in-three hypertensive patients aged 40 to 79 years are diabetics. The DM prevalence in Chinese hypertensive patients aged 40 to 79 years was higher than that obtained in Spain (25.4%) from 420 patients over 18 with essential hypertension [14]. This discrepancy might be attributed to higher average age of the current study patients; indeed, this prevalence is much higher than that of the general Chinese population (9.7%) [3]. A higher DM prevalence for women aged 40 to 79 years was obtained in comparison with male counterparts, suggesting that women with hypertension more easily develop into DM. With increasing age, DM prevalence increased gradually. Nearly two-fifths of hypertensive individuals between 60 and 69 years of age suffered from DM, and the situation was worse between 70 to 79 years, more than two-fifths of hypertensive individuals suffered from DM. With increasing BMI, DM prevalence also tended to increase gradually.

 

Source:

http://doi.org/10.1371/journal.pone.0170250

 

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