Patterns of anti-hypertensive therapy in diabetic patients with and without reduced renal function

Abstract EN

Renal function deterioration is a common complication in patients with diabetes mellitus and hypertension.

Appropriate use of anti-hypertensive agents and tight control of Blood Pressure (BP) can minimize and delay such complications.

This study was performed in order to investigate the utilization patterns of anti-hypertensive agents and to evaluate BP control among diabetic-hypertensive patients with and without reduced renal function.

In a retrospective cohort study, all diabetichypertensive patients attending The Al-Watani Medical Governmental Center from August 01, 2006 until August 01, 2007 were enrolled in the study.

Patients with congestive heart failure and/or endstage renal disease were excluded from the study.

The proportion of use of five different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 drugs, and separately among patients with and without reduced renal function.

Over 60% of patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and (?-blockers (12.5%).

The majority of patients (> 55%) were either on mono or no drug therapy.

Patients on monotherapy were mostly receiving ACEI/ARB (60%).

In patients with reduced renal function, use of diuretics, but not ACEI/ARB or CCB, was higher and 41.8% of the patients were on monotherapy compared to 46.6% in patients with normal renal function.

The proportion of patients achieving good BP control was 20% with monotherapy and 28% with combination therapy.

Our study suggests that the pattern of anti-hypertensive therapy was generally consistent with inter-national guidelines.

Areas of improvement include increasing use of ACEI/ARB and diuretics, decreasing the number of untreated patients, and increasing the proportion of patients with well controlled BP in this population.