Clinical Profile and Antihypertensive Treatment Patterns in Patients with Comorbid Hypertension and Type 2 Diabetes Mellitus: Insights from the National Hypertension Registry

Relevance. The high prevalence of diabetes mellitus among patients with hypertension and the increased risk of cardiovascular complications necessitate a more detailed study of the characteristics of this patient group in order to optimize their management approach. Objective. To identify clinical features of comorbid patients with hypertension and diabetes mellitus, as well as to assess their treatment. Materials and methods. 57396 ambulatory patients from the national registry of hypertension were included in this study. They were divided into 2 groups based on the presence of absence of diabetes mellitus. The assessment of social and anthropometric factors, medical history, modifiable cardio-vascular risk factors was conducted. Statistical analysis was done using R 4.3.3 environment (R foundation for Statistical Computing, Vienna, Austria). Results. Type 2 diabetes mellitus (T2DM) was detected in 15.3% of patients with hypertension (HTN). The group of patients with HTN and type 2 diabetes mellitus was predominantly represented by women (66.6%), who most often had risk factors such as obesity (55.4%) and low physical activity (40.3%). Compared to hypertensive patients without T2DM, those with hypertension and T2DM had significantly higher rates of chronic heart failure (64.4% vs 46.0%), coronary artery disease (54.9% vs 39.0%), chronic kidney disease (35.8% vs 28.3%), and prior cerebrovascular events (7.0% vs 4.1%). Patients with hypertension combined with T2DM demonstrated greater treatment resistance, with more frequent prescriptions of angiotensin receptor blockers (24.7% vs 16.7%), beta-blockers (59.5% vs 51.5%), and calcium channel blockers (22.3% vs 15.1%). Conclusions. The identified changes reflect an additional negative impact of type 2 diabetes on the course of hypertension and the development of cardiovascular complications. Due to the high burden of cardiac and non-cardiac pathologies in this patient group, a more aggressive and multicomponent approach to therapy is required. The obtained results emphasize the need for the development of comprehensive programs for prevention, early diagnosis, and an individualized approach to prescribing therapy. The combination of hypertension and type 2 diabetes in the Russian federation necessitates an interdisciplinary approach with an emphasis on controlling metabolic parameters and the early prevention of complications.