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Hypertension in diabetes: trends in clinical control in repeated large-scale national surveys from Sweden

Journal of Human Hypertension volume 17, pages 37–44 (2003)Cite this article

Abstract

Hypertension in diabetes is an important and treatable cardiovascular risk factor. Treatment targets from guidelines cannot always be achieved in everyday clinical practice. It is therefore of great importance to monitor trends in hypertension control in defined populations. Patients with type I diabetes (range 6685–10 100; treated hypertension 21–29%) or with type II diabetes (range 15 935–22 605; treated hypertension 47–56%) were included in four national samples between 1996 and 1999. This screening was part of the procedures for the National Diabetes Register in Sweden, which monitors trends in clinical practice and risk factors for patients with diabetes, recruited both in primary health care and at the hospital level. A favourable trend in mean and median blood pressure levels was noticed during the 4-year study period, based either on data from repeated surveys or on repeated measures in the same individual, both for type I diabetes (mean: −2/−2 mmHg; P<0.01) and for type II diabetes (mean: −5/−3 mmHg; P<0.001). Correspondingly, the proportion of hypertensive patients in acceptable control of blood pressure (⩽140/85 mmHg) increased (P<0.001) both in type I diabetes (52.0–57.9%) and in type II diabetes (22.4–33.3%). It was concluded that hypertension is a widespread cardiovascular risk factor in patients with diabetes, especially systolic hypertension. A trend for a better systolic blood pressure control during the late 1990s in hypertensive patients with type II diabetes in Sweden could translate into substantial (estimated) clinical benefits in cardiovascular and diabetes-related morbidity. The National Diabetes Register makes a quality assessment of the hypertension treatment possible.

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Acknowledgements

The NDR Working Group in Sweden presently consists of Soffia Gudbjörnsdottir (national coordinator), Björn Eliasson (data report manager), Jan Cederholm (statistical expert of the data report group), Peter Nilsson, Thomas Fritz, and Gunnar Carlgren (representatives of primary health care centres), and Christian Berne (chairman of the Swedish Association of Diabetology and the Register Working Group). Anders Nilsson and Göran Blohmé were in charge of the register during 1996–2000, and without their outstanding pioneering efforts the register would not have been working today. Carl-David Agardh implemented the idea of a national register in 1995.

We thank all the participating physicians, nurses, and other staff members who have contributed data to the NDR. Most of all we thank the diabetes patients who both individually and collectively, via their organisation the Swedish Diabetes Federation, have supported the NDR.

The NDR is supported financially by the Swedish Board of Health and Welfare, Stockholm. Data management and its compilation into the computerised register have been handled on a daily basis by staff at Lunds Datacentral (LDC), Lund, Sweden.

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Authors and Affiliations

  1. Department of Medicine, University Hospital, Malmö, Sweden

    P M Nilsson

  2. Diabetes Centre, Sahlgrenska University Hospital, Göteborg, Sweden

    S Gudbjörnsdottir & B Eliasson

  3. Department of Public Health and Caring Sciences, Family Medicine Section, Uppsala University, Uppsala, Sweden

    J Cederholm

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  1. P M Nilsson
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for the Steering Committee of the National Diabetes Register, Sweden

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Correspondence to P M Nilsson.

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Nilsson, P., Gudbjörnsdottir, S., Eliasson, B. et al. Hypertension in diabetes: trends in clinical control in repeated large-scale national surveys from Sweden. J Hum Hypertens 17, 37–44 (2003). https://doi.org/10.1038/sj.jhh.1001503

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