Pharmacological management of hypertension in diabetic patients

Background and Objective: The 2007 'Guidelines for the Management of
Arterial Hypertension (HT)' and 'Guidelines on diabetes, pre-diabetes and cardiovascular
diseases'issued by the TaskForcefor the Management of Arterial
HTof the European Society of Hypertension and the European Society of Cardiology
recommend angiotensin converting enzyme (ACE) inhibitors or
angiotensin II receptor anuqonists (ARBs) as first line treatment for HT in
patients with diabetes mellirus. The aim of this epidemiological study was to
determine whether first line pharmacoloqical manaqement of HTin diabetic
patients in Malta is in accordance with these European guicielines.
Setting and Method: Four-weekaudit at Diabetesand EndocrineCentre,MDH.
Theguidelines were extensively scrutinised, 125patient files were collected.Current
prescribedmedications, medication history, ro-morblditl-s dnd laboratory
investigationswere reviewed and tabulated in a data collection form. Comparison
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POSTER DISCUSSION FORUM III
to the guidelines and descriptive statistics were undertaken.
Main outcome .neasures: Audit of pharmacological management of HTin
diabetic patients according to European guidelines.
Results: The majority of patients (93°il) were on ACEinhibitor (7200) or ARB
WOo) therapy in accordance with the guidelines. The most frequently prescribed
ACEinhibitor was perindopril (6106), followed by enalapril (3790).The
most frequently prescribed ARBwas valsartan (8900), followed by iosartan
(12°0). Of the 7°0 (9) of patients who were not on ACEinhibitor or ARBtreatment
tnere ",as a justified reason in 6°'0 (3) of these patients; an elevated
potassium and/or creatinine level. 32Qo of patients were on 1 or more diuretics
(20 on bendroflumethiazide: 17 on bumetanide), 28Qoof patients were on a
calcium channellJlocker (all on amlodipine) and 19°0 of patients were on a
beta-blocker, predominantly atenolol (21 patients).
Conclusions: Pharmacological management of HTin diabetic patients in Malta
is in accordancewith European guidelines for the majority of patients assessed
in this audit.

Publication year:2013

Keywords:pharmacological management, diabetic patients