Open Access Original investigation

Blood pressure and lipid management fall far short in persons with type 2 diabetes: results from the DIAB-CORE Consortium including six German population-based studies

Ina-Maria Rückert1*, Michaela Schunk2, Rolf Holle2, Sabine Schipf3, Henry Völzke3, Alexander Kluttig4, Karin-Halina Greiser45, Klaus Berger6, Grit Müller6, Ute Ellert7, Hannelore Neuhauser7, Wolfgang Rathmann8, Teresa Tamayo8, Susanne Moebus9, Silke Andrich9 and Christa Meisinger110

Author Affiliations

1 Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstrasse 1, D-85764, München/Neuherberg, Germany

2 Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany

3 Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany

4 Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany

5 Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany

6 Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany

7 Department of Epidemiology and Health Reporting, Robert-Koch-Institute, Berlin, Germany

8 Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes, Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany

9 Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany

10 MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany

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Cardiovascular Diabetology 2012, 11:50  doi:10.1186/1475-2840-11-50

Published: 8 May 2012

Abstract

Background

Although most deaths among patients with type 2 diabetes (T2D) are attributable to cardiovascular disease, modifiable cardiovascular risk factors appear to be inadequately treated in medical practice. The aim of this study was to describe hypertension, dyslipidemia and medical treatment of these conditions in a large population-based sample.

Methods

The present analysis was based on the DIAB-CORE project, in which data from five regional population-based studies and one nationwide German study were pooled. All studies were conducted between 1997 and 2006. We assessed the frequencies of risk factors and co-morbidities, especially hypertension and dyslipidemia, in participants with and without T2D. The odds of no or insufficient treatment and the odds of pharmacotherapy were computed using multivariable logistic regression models. Types of medication regimens were described.

Results

The pooled data set comprised individual data of 15, 071 participants aged 45–74 years, including 1287 (8.5%) participants with T2D. Subjects with T2D were significantly more likely to have untreated or insufficiently treated hypertension, i.e. blood pressure of > = 140/90 mmHg (OR = 1.43, 95% CI 1.26-1.61) and dyslipidemia i.e. a total cholesterol/HDL-cholesterol ratio > = 5 (OR = 1.80, 95% CI 1.59-2.04) than participants without T2D. Untreated or insufficiently treated blood pressure was observed in 48.9% of participants without T2D and in 63.6% of participants with T2D. In this latter group, 28.0% did not receive anti-hypertensive medication and 72.0% were insufficiently treated. In non-T2D participants, 28.8% had untreated or insufficiently treated dyslipidemia. Of all participants with T2D 42.5% had currently elevated lipids, 80.3% of these were untreated and 19.7% were insufficiently treated.

Conclusions

Blood pressure and lipid management fall short especially in persons with T2D across Germany. The importance of sufficient risk factor control besides blood glucose monitoring in diabetes care needs to be emphasized in order to prevent cardiovascular sequelae and premature death.

Keywords:
Type 2 Diabetes; Hypertension; Dyslipidemia; Adherence to guidelines; Pharmacological treatment