Medicine Usage for Hypertension Management in Type 2 Diabetes Patients in the Rural-Urban Fringe Zone, Suzhou City, Jiangsu Province, China.

Abstract

Objective: Medicine is critical for blood-pressure control in patients with type 2 diabetes mellitus (T2DM), for evaluation of treatment patterns and effects would offer baselines for future health services.

Methods: A cross-sectional study was conducted from August 2018 to January 2021 in the urban-rural fringe zone of Suzhou City, Jiangsu Province, China. Blood pressure and antihypertensive medication use were collected from T2DM patients combined with hypertension (HTN). Using systolic blood pressure (SBP) and diastolic blood pressure (DBP) <140/85 mmHg as HTN controls, medicine usage patterns were analyzed.

Results: Among the 931 T2DM patients with HTN, 333 (37.0%, 95% CI: 33.8%-40.2%) had HTN controlled with SBP and DBP of <140/85 mmHg. Partial following the medicine recommendations for HTN control were observed in this zone, and calcium channel blocker (CCB), angiotensin II receptor blocker (ARB), diuretics and β-receptor blocker (Βeta-blocker) were the most frequently used ones, especially for CCB and ARB, which accounted for 67% (625/931) and 55% (509/931), respectively. For combination usage, complete adherence to the recommendation was observed, ie, ARB + CCB and ARB + diuretics were listed as the top two, accounting 30% (282/931) and 16% (153/931), respectively. Combination therapies had HTN control rates ranging from 31.1% to 39.1%, lower than those of monotherapy (>40%). In monotherapies, CCB had control rate of 41.2% (115/279, 95% CI 35.4%-47.2%), higher than combination (31.9%, 105/329, 95% CI 26.9%-37.3%), as well as ARB; the single reagent had control rate of 42.0% (95% CI 33.7%-50.7%), higher than combination (32.2%, 95% CI 27.4%-37.3%).

Conclusions: More than 60% of T2DM patients had blood-pressures above the target level and the pattern of medications for HTN control in T2DM patients followed the recommendation of the authorities; however, the effects were not as expected, and more antihypertensive medicines or combinations would not raise the HTN control rate.