Does glycemic control reduce cardiovascular complications

Abstract EN

Objective : To evaluate the association between glycemic control and hypertensive crisis.

Design : A Cross Sectional Study.

Setting : Cardiology Unit, Salmaniya Medical Complex.

Method : One hundred forty-five patients with diabetes mellitus, above 18 years admitted from 1 June 2010 to 31 December 2010 for a hypertensive crisis were reviewed.

A control group consisted of 145 diabetic patients, age and sex matched, without hypertensive crisis were recruited for the study.

A hypertensive crisis is classified into urgency or emergency, based on the absence or presence of acute target organ involvement.

Glycated hemoglobin (HbA1c) level of ≤53 mmol/mol is the threshold for good glycemic control.

The relationship between various clinical presentation and HbA1c was assessed.

Result : One hundred forty-five were reviewed, 87 (60 %) were males and 58 (40 %) were females.

Twenty-six (18 %) of the crisis group had HbA1c of ≤ 53 mmol / mol ; 75 (52 %) of the control subjects had HBA1c < 53 mmol / mol, (P value ≤ 0.0001).

Among the hypertensive crisis group, the rate of hypertensive emergencies, 84 (58 %), was greater than those of hypertensive urgencies, 61 (42 %).

Left ventricular failure (LVF) was the most common clinical presentation.

Poor glycemic control was closely related to hypertensive emergency (P value = 0.042).

Patients with HBA1c < 53 mmol / mol had lower rates of hypertensive emergencies than those with HBA1c >53mmol/mol, 11 (42 %) and 75 (63 %), respectively.

Conclusion : It was found that hypertensive patients with good glycemic control are at a lesser risk of getting emergency hypertensive crisis.

Controlling diabetes may confer protection against hypertensive crisis and in particular, emergencies and the related cardiovascular complications.