Arterial hypertension as a risk factor in the cardiovascular complications of diabetes mellitus

: Diabetic patients suffer from atherosclerosis and its complications more frequently and at an earlier stage than nondiabetic people. The factors predisposing diabetics to premature arteriosclerosis are not fully clarified. Data from a 5-year follow-up of 617 diabetics, 376 non-insulin dependent (NIDDM) and 241 insulin-dependent (IDDM), attending the Hospital de Clinicas Jose de San Martin at Buenos Aires city are reported. By the WHO criteria 55% of NIDDM and 29% of IDDM had hypertension. Hypertension was significantly (p less than 0.01) more common among NIDDM than among IDDM patients after adjustment for age, sex and obesity. The incidence of angor pectoris, acute myocardial infarction and heart failure was significantly greater in hypertensive patients of both types of diabetes than in the respective normotensive group. No sex differences were observed in both diabetic groups in the incidence rates of coronary heart disease. Overt diabetic nephropathy and diabetic retinopathy were more frequent in hypertensives than in normotensives of both groups of diabetics. Even though 63% of hypertensive patients with NIDDM and 57% with IDDM received antihypertensive treatment only 36% and 24% respectively had their blood pressure well controlled. Acute myocardial infarction was the most frequent cause of death in both NIDDM and IDDM hypertensive people.