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| |  ERA-EDTA: Hypertension, Albuminuria Inadequately Managed in Diabetics By Danny Kucharsky COPENHAGEN, DENMARK -- July 19, 2002 -- Hypertension is often left untreated and albuminuria is inadequately managed in patients with type 2 diabetes in primary care settings, concludes an Italian study presented here July 17 at the XXXIX Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA). Dr. Roberto Boero, a nephrologist at San Giovanni Bosco Hospital in Turin, Italy, also said the importance of systolic hypertension is underestimated in these patients and there is suboptimal usage of antihypertensive drugs. The study identified 5,815 diabetics in the first half of 2000 in an area of about 200,000 people, through prescriptions for insulin, hypoglycemic drugs or both. Of these, 171 type 2 diabetes patients were randomly selected, 99 of whom had prescriptions for anti-hypertensive drugs. Over half the patients were male, with a mean age of 66.6 years and a mean diabetes duration of 12 years. The study found that 56 percent of patients on anti-hypertensive drugs and 57 percent of patients not being treated for hypertension had systolic blood pressure (BP) of between 130 and 159 mmHg. (Hypertension was defined as BP 130 mmHg or greater.) Only 13 percent of those taking anti-hypertensive medication had a BP < 130/85 mmHg. Among the anti-hypertensive treated group, 36 percent were receiving one drug, 36 percent were receiving two drugs and 28 percent were receiving three or more drugs. Angiotensin-converting enzyme inhibitors (ACE-I) were the most often used drugs. The study also found 60 percent of those treated with two drugs and 22 percent of those receiving three or more drugs were not receiving a diuretic. Dr. Boero said there was a 19.9 percent prevalence of micro-albuminuria and 12.5 percent prevalence of macro-albuminuria in patients treated with anti-hypertensive medication. For the non-treated group, the percentages were 38.4 percent and 3 percent, respectively. Moreover, just over two-thirds of micro-albuminuria and slightly over one-third of macro-albuminuria patients were not receiving ACE-I or an angiotensin II type 1 receptor antagonist, Dr. Boero said. Proper treatment of albuminuria and hypertension could delay the development of renal and cardiovascular complications in type 2 diabetes patients, he noted.
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