Abstract P058: Impact of Comorbid Hypertension and Obesity on Glycemic Control in Adults with Type 2 Diabetes Mellitus from a National Representative US Population
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a concerning epidemic, and sub-optimal glycemic control could lead to higher risk of complications and needs for additional care. Hypertension and obesity are common comorbid conditions, yet their impact on glycemic control has not been quantified. We hypothesize that comorbid hypertension and/or obesity are associated with a higher likelihood of uncontrolled glycemic level.
METHODS: Data from a nationally representative sample of US population participating in the National Health and Nutrition Examination Survey (NHANES) 2003-2010 were analyzed in a cross-sectional retrospective observational study. Adults aged 20 years or older with self-reported diabetes and anti-diabetes medication use were included. Pregnant women were excluded. T2DM was defined by excluding diabetes patients who were diagnosed before age 30 and took only insulin. Uncontrolled hypertension was defined as blood pressure of ≥130 mmHg (systolic) or ≥80 mmHg (diastolic) based on American Diabetes Association’s guidance for hypertension in diabetes patients. Obesity was determined if body mass index ≥30 kg/m2. Uncontrolled glycemic level was defined as HbA1c ≥7%. We estimated the prevalence of uncontrolled hypertension and obesity among T2DM patients. Rates of uncontrolled glycemic level were reported and compared by uncontrolled hypertension and/or obesity status using Chi-square tests. Population weights were applied to account for multi-stage sampling design to produce nationally representative estimates.
RESULTS: After applying the population weights to the 2,203 respondents with T2DM, findings from these respondents were extrapolated to an estimated 15.4 million T2DM patients in the US (prevalence of T2DM=7.4%), of which 61.1% were obese. Among US T2DM patients, the prevalence of uncontrolled hypertension was 52.6%. Among US T2DM patients, the prevalence of patients who had uncontrolled hypertension and who were obese was 31.2%. No statistically significant differences were found in uncontrolled glycemic level rates between those with and without uncontrolled hypertension (44.0% vs. 41.0%; p=0.31). Obese patients had a statistically significant higher rate of uncontrolled glycemic level than non-obese (44.5% vs. 37.9%; p=0.03). T2DM patients with comorbid uncontrolled hypertension and obesity had a statistically significant higher rate of uncontrolled glycemic level than the rest of the T2DM patients (47.1% vs. 40.0%; p=0.02).
CONCLUSIONS: Prevalence of uncontrolled hypertension and obesity was high in US adults with T2DM. Obese patients, especially those who had uncontrolled blood pressure, had sub-optimal glycemic control. Interventions targeting these patients should be considered.
- © 2013 by American Heart Association, Inc.