Risk Management and Healthcare Policy (Nov 2022)
Trends and Comparisons of Blood Pressure and Fasting Plasma Glucose in Patients with Hypertension, Diabetes, and Comorbidity: 4-Year Follow-Up Data
Abstract
Luxinyi Xu,1,2 Xiaotong Wen,1,2 Ying Yang,1,2 Dan Cui1,2 1School of Public Health, Wuhan University, Wuhan, 430071, People’s Republic of China; 2Global Health Institute, Wuhan University, Wuhan, 430071, People’s Republic of ChinaCorrespondence: Dan Cui, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, People’s Republic of China, Tel +86 133 1715 0755, Email [email protected]: Patients with both diabetes and hypertension could face more health risks than those with either condition alone, and less attention has been paid to their management outcomes, so this study may be the first to specifically address this problem. We aimed to examine the management outcomes of blood pressure (BP) in hypertensive patients with/without diabetes and fasting plasma glucose (FPG) in diabetic patients with/without hypertension.Methods: Follow-up data were obtained from the National Basic Public Health Service Project in Sanming (2017– 2021). A total of 25,795 adults with hypertension only, 4111 adults with diabetes only, and 5729 comorbid adults (namely, hypertensive patients with diabetes) were included. Generalized estimating equations were applied.Results: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension only both dropped significantly (Coef. = − 0.00088, P < 0.001; Coef. = − 0.00081, P < 0.001). DBP in comorbid patients decreased considerably (Coef. = − 0.00033, P < 0.001). Pulse pressure in comorbid patients grew rapidly (Coef. = 0.00044, P < 0.001). BP control rate in patients with hypertension only increased significantly (OR = 1.00039, P < 0.001). FPG control rates in diabetic patients with/without hypertension grew markedly (OR = 1.00013, P < 0.001; OR = 1.00020, P < 0.001). Comorbid patients had lower baseline SBP and DBP but higher latest SBP than patients with hypertension only (Coef. = − 1.18872, P < 0.001; Coef. = − 1.16049, P < 0.001; Coef. = 1.0634, P < 0.001). Comorbid patients had lower baseline BP and FPG control rates than those with either condition alone, and differences were greater at the latest follow-up (OR = 0.28086, P < 0.001; OR = 0.91012, P = 0.049; OR = 0.04020, P < 0.001; OR = 0.69465, P < 0.001).Conclusion: BP and FPG management outcomes have achieved progress. Comorbid patients have poorer performance than patients with either disease alone in BP levels especially the SBP level and control rates of SBP, DBP, and FPG. Future studies should be conducted using national data and include more confounding factors.Keywords: hypertension, diabetes mellitus, comorbidity, blood pressure, fasting plasma glucose, longitudinal studies
