Prevalence Of Hypertension And Albuminuria In A Teaching Hospital Diabetes Clinic

The prevalence of hypertension and its relationship to nephropathy were measured in a hospital-based diabetic clinic. Six hundred patients (300 insulin treated, 300 non-insulin treated) were randomly selected from a clinic population of 1054 insulin treated and 1039 non-insulin treated subjects. Eighty-three percent of patients with insulin treated diabetes and 72% of patients with non-insulin treated diabetes were studied. Blood pressure data from the Belfast MONICA project were used for the control group. In patients with insulin treated diabetes (age 25-64 years) the prevalence of a systolic blood pressure > 160 mmHg or a diastolic blood pressure > 95 mmHg or on treatment for hypertension (WHO criteria) was 19.1% in males CNS, vs. control group) and 17.8% in females (NS); the prevalence of a systolic blood pressure > 140 mmHg and diastolic blood pressure > 90 mmHg was 17.6% in males (NS, vs. control group) and 9.5% in females (NS). In patients with non-insulin treated diabetes (age 35-65 years) the prevalence of hypertension by WHO criteria (see above) was 26.8% in males (NS, vs. control group) and 28.9% in females (NS); the prevalence of a systolic blood pressure > 140 mmHg and diastolic blood pressure > 90 mmHg was 21.4% in males (NS, vs. control group) and 17.8% in females (NS). Six percent (n = 14) of patients with insulin treated diabetes and 6.7% (n = 13) of patients with non-insulin treated diabetes had a random urinary albumin concentration > 300 mu g/ml and 19.7% (n = 46) of insulin treated and 24.1% (n = 47) of non-insulin treated subjects had micro-albuminuria (urinary albumin concentration 35-300 mu g/ml. There was a strong association between hypertension and nephropathy in patients with insulin treated diabetes (P < 0.001, Chi squared test) but no association in patients with non-insulin treated diabetes. In conclusion there was no excess of hypertension in our diabetic population, but there was a high prevalence of microalbuminuria.