We investigated the presence of both hypertension and diabetes mellitus in two management settings, namely cardiology and endocrinology, and its association with albuminuria while accounting for the management of these two diseases.Design and Method:
Our multicentre registry included patients (≥ 20 years) seen for hypertension in cardiology or for diabetes mellitus in endocrinology. We administered a questionnaire and measured blood pressure, glycosylated haemoglobin A1c (HbA1c) and albuminuria.Results:
The presence of both hypertension and diabetes was observed in 32.9% of hypertensive patients in cardiology (n = 1291) and 58.9% of diabetic patients in endocrinology (n = 1168). Presence of both diseases was associated with a significantly (P ≤ 0.01) higher use of combination antihypertensive therapy in cardiology (odds ratio 1.36). The control of hypertension and diabetes was not different between patients with both diseases and those with either condition alone (P≥0.08), regardless of the therapeutic target (systolic/diastolic blood pressure < 140/90 or 130/80 mmHg and HbA1c <7.0% or 6.5%) or management setting. The prevalence of albuminuria, however, was higher (P ≤ 0.02) in the presence of both diseases (23.3%) than those with either hypertension (12.6%) or diabetes alone (15.9%), especially in uncontrolled hypertension (systolic/diastolic pressure ≥140/90 mmHg), which was associated with a higher risk of albuminuria in the presence (odds ratio 2.48, P = 0.004) but not absence of diabetes (P = 0.17).Conclusions:
The presence of both hypertension and diabetes mellitus was prevalent, especially in the endocrinology setting. It was associated with higher risk of target organ damage, and required more intensive management and better control of both conditions, particularly hypertension.