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Renal Function Alters Antihypertensive Regimens in Type 2 Diabetic Patients.

Abstract
To determine the prevalence of multidrug antihypertensive therapy (MDAT), records were evaluated for patients with both type 2 diabetes and hypertension during a 5-year period at Joslin Diabetes Center. Hypertension control was defined as requiring multiple drugs if three or more antihypertensive drugs were used, one of which must be a diuretic (unless patient is receiving dialysis), or use of four or more antihypertensive drugs, one of which a diuretic (unless patient is receiving dialysis) was established. The objective was to determine the prevalence of multidrug requirement for hypertensive therapy in relationship to four levels of renal function estimated by the Modification of Diet in Renal Disease formula for glomerular filtration rate (GFR). Among 10,151 patients, mean estimated GFR was 80 mL/min. Using standard (ASN) classification for renal function, we noted the following breakdown of MDAT use: Estimated GFR Drugs, Mean No. ≥3 Drugs, No. (%) ≥4 Drugs, No. (%) <30 3.1 379 (67) 214 (38) 30-60 2.7 1233 (55) 538 (24) 60-90 2.0 1279 (33) 458 (12) >90 1.5 600 (17) 185 (5) Prevalence of multidrug antihypertensive therapy is markedly increased in the presence of reduced renal function.
AuthorsLarry A Weinrauch, George Bayliss, Alissa R Segal, Jiankang Liu, Eric Wisniewski, John A D'Elia
JournalJournal of clinical hypertension (Greenwich, Conn.) (J Clin Hypertens (Greenwich)) Vol. 18 Issue 9 Pg. 878-83 (09 2016) ISSN: 1751-7176 [Electronic] United States
PMID26932730 (Publication Type: Journal Article)
Copyright© 2016 Wiley Periodicals, Inc.
Chemical References
  • Antihypertensive Agents
Topics
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents (therapeutic use)
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 (complications, physiopathology)
  • Drug Therapy, Combination (statistics & numerical data)
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension (drug therapy)
  • Kidney (physiopathology)
  • Male
  • Middle Aged

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