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Metabolic disorders associated with uncontrolled hypertension.

Abstract

AIM

To examine the prevalence and characteristics of uncontrolled hypertension (HT).

METHODS

A cross-sectional community-based study (1992-93) was carried out in Skara, Sweden, including 894 patients who consecutively underwent an annual follow-up at the hypertension outpatient clinic in primary care. Controlled HT was defined as diastolic blood pressure (DBP) < or =90 mmHg and systolic blood pressure (SBP) < or =160 mmHg and was used as reference. Uncontrolled DBP was defined as DBP >90 mmHg regardless of SBP level, and isolated uncontrolled SBP was defined as SBP >160 mmHg and DBP < or =90 mmHg. Proportions were age-standardized using the Skara population as reference.

RESULTS

The prevalence of uncontrolled HT was 43% (isolated uncontrolled SBP 18% and uncontrolled DBP 25%). Both men and women with isolated uncontrolled SBP were older (73 years, CI: 70-75; and 73 years; CI: 72-75) than patients with controlled HT (64 years, CI: 63-66; and 65 years, CI: 64-66). Men and women with known cardiovascular disease (CVD) less often had isolated uncontrolled SBP (OR: 0.4, CI: 0.2-0.9; and OR: 0.5, CI: 0.3-0.9), whereas men and women with known diabetes more often had uncontrolled DBP (OR: 2.3, CI: 1.3-4.1; and OR: 3.3, CI: 1.9-5.7). Men with known CVD less often had uncontrolled DBP (OR: 0.5, CI: 0.3-1.0, p = 0.04), and men with fasting blood glucose >5.5 mmol/l more often had isolated uncontrolled SBP (OR: 1.9, CI: 1.0-3.5, p = 0.04). In women, the following high risk factor levels were associated with uncontrolled DBP: fasting blood glucose >5.5 mmol/l (OR: 1.4, CI: 1.1-1.8), fasting triglycerides > or =1.7 mmol/l (OR: 1.4, CI: 1.1-1.8), body mass index (BMI) >30 kg/m2 (OR: 1.5, CI: 1.1-1.9), waist/hip ratio (WHR) >0.85 cm/cm (OR: 1.7, CI: 1.3-2.2), insulin resistance (homeostasis model assessment (HOMA) >third quartile) (OR: 1.4, CI: 1.1-1.9) and microalbuminuria (OR: 3.2, CI: 1.7-6.2).

CONCLUSION

Uncontrolled DBP is in both sexes related to type 2 diabetes, whereas isolated uncontrolled SBP is related to older age. In women, uncontrolled DBP, furthermore, is related to several other CVD risk factors of the metabolic syndrome. Patients with uncontrolled DBP should be carefully evaluated for metabolic disorders.

Links

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  • Authors+Show Affiliations

    ,

    Department of Community Medicine, Malmö University Hospital, Malmö, Sweden Skara Health Care Centre, Skara, Sweden. erik.bog-hansen@vgregion.se

    , , ,

    Source

    Diabetes, obesity & metabolism 5:6 2003 Nov pg 379-87

    MeSH

    Adult
    Age Factors
    Aged
    Aged, 80 and over
    Blood Glucose
    Cardiovascular Diseases
    Cross-Sectional Studies
    Diabetes Mellitus, Type 2
    Female
    Humans
    Hypertension
    Insulin Resistance
    Lipids
    Male
    Middle Aged
    Prevalence
    Risk Factors
    Sex Factors
    Sweden

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    14617223

    Citation

    Bøg-Hansen, E, et al. "Metabolic Disorders Associated With Uncontrolled Hypertension." Diabetes, Obesity & Metabolism, vol. 5, no. 6, 2003, pp. 379-87.
    Bøg-Hansen E, Lindblad U, Gullberg B, et al. Metabolic disorders associated with uncontrolled hypertension. Diabetes Obes Metab. 2003;5(6):379-87.
    Bøg-Hansen, E., Lindblad, U., Gullberg, B., Melander, A., & Råstam, L. (2003). Metabolic disorders associated with uncontrolled hypertension. Diabetes, Obesity & Metabolism, 5(6), pp. 379-87.
    Bøg-Hansen E, et al. Metabolic Disorders Associated With Uncontrolled Hypertension. Diabetes Obes Metab. 2003;5(6):379-87. PubMed PMID: 14617223.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Metabolic disorders associated with uncontrolled hypertension. AU - Bøg-Hansen,E, AU - Lindblad,U, AU - Gullberg,B, AU - Melander,A, AU - Råstam,L, PY - 2003/11/18/pubmed PY - 2004/7/31/medline PY - 2003/11/18/entrez SP - 379 EP - 87 JF - Diabetes, obesity & metabolism JO - Diabetes Obes Metab VL - 5 IS - 6 N2 - AIM: To examine the prevalence and characteristics of uncontrolled hypertension (HT). METHODS: A cross-sectional community-based study (1992-93) was carried out in Skara, Sweden, including 894 patients who consecutively underwent an annual follow-up at the hypertension outpatient clinic in primary care. Controlled HT was defined as diastolic blood pressure (DBP) < or =90 mmHg and systolic blood pressure (SBP) < or =160 mmHg and was used as reference. Uncontrolled DBP was defined as DBP >90 mmHg regardless of SBP level, and isolated uncontrolled SBP was defined as SBP >160 mmHg and DBP < or =90 mmHg. Proportions were age-standardized using the Skara population as reference. RESULTS: The prevalence of uncontrolled HT was 43% (isolated uncontrolled SBP 18% and uncontrolled DBP 25%). Both men and women with isolated uncontrolled SBP were older (73 years, CI: 70-75; and 73 years; CI: 72-75) than patients with controlled HT (64 years, CI: 63-66; and 65 years, CI: 64-66). Men and women with known cardiovascular disease (CVD) less often had isolated uncontrolled SBP (OR: 0.4, CI: 0.2-0.9; and OR: 0.5, CI: 0.3-0.9), whereas men and women with known diabetes more often had uncontrolled DBP (OR: 2.3, CI: 1.3-4.1; and OR: 3.3, CI: 1.9-5.7). Men with known CVD less often had uncontrolled DBP (OR: 0.5, CI: 0.3-1.0, p = 0.04), and men with fasting blood glucose >5.5 mmol/l more often had isolated uncontrolled SBP (OR: 1.9, CI: 1.0-3.5, p = 0.04). In women, the following high risk factor levels were associated with uncontrolled DBP: fasting blood glucose >5.5 mmol/l (OR: 1.4, CI: 1.1-1.8), fasting triglycerides > or =1.7 mmol/l (OR: 1.4, CI: 1.1-1.8), body mass index (BMI) >30 kg/m2 (OR: 1.5, CI: 1.1-1.9), waist/hip ratio (WHR) >0.85 cm/cm (OR: 1.7, CI: 1.3-2.2), insulin resistance (homeostasis model assessment (HOMA) >third quartile) (OR: 1.4, CI: 1.1-1.9) and microalbuminuria (OR: 3.2, CI: 1.7-6.2). CONCLUSION: Uncontrolled DBP is in both sexes related to type 2 diabetes, whereas isolated uncontrolled SBP is related to older age. In women, uncontrolled DBP, furthermore, is related to several other CVD risk factors of the metabolic syndrome. Patients with uncontrolled DBP should be carefully evaluated for metabolic disorders. SN - 1462-8902 UR - https://www.unboundmedicine.com/medline/citation/14617223/Metabolic_disorders_associated_with_uncontrolled_hypertension_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=1462-8902&amp;date=2003&amp;volume=5&amp;issue=6&amp;spage=379 DB - PRIME DP - Unbound Medicine ER -