BP Control in Diabetes Prevents Organ Injuries

Tight blood pressure control is likely a key step in preventing hypertensive emergencies and life-threatening target organ injuries among patients with diabetes, new research shows.

A study performed by researchers at the Rutgers School of Nursing in New Jersey found that patients with comorbid diabetes and severely elevated blood pressure accounted for more than half of individuals who presented to the emergency department for a hypertensive emergency.

YOU MAY ALSO LIKE
ADA/EASD Release Updated Joint Diabetes Recommendations
Diabetes Drug Reduces Cardiovascular Event Risk

Irina Benenson, DNP, FNP-C, CEN, assistant professor at the Rutgers School of Nursing, and colleagues arrived at their conclusion after evaluating the electronic medical records of patients with diabetes (n = 783) who presented to the emergency department of Newark Beth Israel Medical Center in New Jersey for a hypertensive crisis.

These patients were compared with individuals without diabetes (n = 1001) based on demographic and clinical factors.

Ultimately, 264 study participants experienced hypertensive emergencies, and 519 had hypertensive urgencies. Approximately 52.27% of all hypertensive emergencies in this cohort occurred in patients with diabetes.

“The development of hypertensive emergencies in patients with diabetes was not because of diabetes per se but because of coexisting highly elevated blood pressure,” the researchers wrote.

“Tight blood pressure control may decrease the risk of hypertensive emergencies in this patient population,” they added.

Patients with diabetes who also had hyperlipidemia, coronary artery disease, congestive heart failure, renal insufficiency, and/or low hemoglobin were significantly more likely to experience a hypertensive emergency (odds ratios: 1.66, 2.95, 6.28, 2.84, and 0.9, respectively).

Patients with and without diabetes were found to experience similar rates of target organ injuries, with the most frequent acute target organ injury being acute or worsening heart failure (49.6%), followed by non-ST elevation myocardial infarction (41.7%).

Of note, approximately 88.6% of study participants were African American—a population known to have a disproportionately high risk of developing hypertension and related complications.

—Christina Vogt

Reference:

Benenson I, Waldron FA, Jones Dillon SA, et al. Hypertensive emergencies in diabetic patients from predominantly African American urban communities [Published online October 4, 2018]. Clin Exp Hypertens. https://doi.org/10.1080/10641963.2018.1516774