Document Details
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Document Type |
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Article In Journal |
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Document Title |
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Cardiovascular risk factors in Saudi and non –Saudi diabetics Cardiovascular risk factors in Saudi and non –Saudi diabetics |
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Document Language |
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English |
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Abstract |
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Cardiovascular disease (CVD) is the leading cause of morbidity and death. Diabetes mellitus (OM) is closely associated with ischemic heart disease (IHD) and patients with OM and no previous history of IHD have the same risk for cardiac events as patients with previous myocardial infarction. Hyperlipidemia, hypertension, smoking and obesity are well known modifiable cardiovascular risk factors in both diabetics and non-diabetics.' This work aimed to evaluate the prevalence of CVD risk factors in diabetics in 2 different nationalities (Saudis and non-Saudis).
We studied diabetic patients attending in King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia, for follow-up from January 1999 to December 200 I. Cardiovascular disease risk factors include hypertension (patient is known or has 2 consecutive readings >130 mm Hg systolic, 85 mm Hg diastolic), hyperglycemia (if the patient is known or with LDL >2.6 mmol/I, triglyceride >2.3 rnmol/l, HDL <0.9 mmol/I for males and one mmol/I for females), obesity (defined as body mass index >30% kg/m-), smoking history (either active or 5 years ex-smoker) was recorded from the medical records of the study group. In addition, participant's age, sex, nationality, degree of blood glucose control (poor blood glucose control defined as the mean of the most recent 2 hemoglobin Alc (HbAlc) readings >9%), and duration of OM were recorded. The study group was divided into 2 groups according to their
Table 1 - Comparison between Saudis and non-Saudis according to some variables.
sr
Variables Saudis Non-Saudis p-value
n (%) n (%)
Hypertension 287 (53) 302 (52) 0.6
Hyperlipidemia 249 (46) 250 (43) 0.4
Obesity 114 (21) 110 (19) OJ
Smoking 303 (56) 343 (59) 0.5
J-1bAlc>9% 384 (71) 383 (66) 0.06
Mean duration of OM 8.9 ± 7.3 8.8 ± 7.2 0.2
(years ± SO)
HbA I c - hemoglobin A I c, OM - diabetes mellitus
686 Saudi Med ] 2003; Vol. 24 (6) www.smj.org.sa
nationality whether Saudis or non-Saudis and comparative analysis was made between them regarding the prevalence of CVD risk factors and degree of blood glucose control.
One thousand one hundred and fifty-five diabetic patients were studied. Thirty-five (3%) were excluded as they have missing values and the remaining 1 122 were included in the study. Five hundred and forty-one (48%) were Saudis with male to female ratio of 1.3: I, while non-Saudis were 581 (52%) with male to female ratio of 1.1: 1 (p 0.3). Four hundred and six (75%) were ~45 years of age compared to 407 (70%) non-Saudis (p 0.06). Hypertension, hyperlipidemia, and smoking were common CVD risk factors in both Saudis and non-Saudis while obesity was less common in both groups. Both nationalities have poor blood glucose control (Table 1). Age was considered a risk factor for CVD in diabetics especially among individuals aged 45-74 years. The majority of our patients whether Saudis or non-Saudis was ~45 years. It is well known that individuals with diabetes have a high risk of morbidity and premature death associated with the development of macrovascular complications especially among smokers. Smoking cessation is one of the few interventions that can safely, and cost effectively recommended for all patients. Data from the recent United Kingdom Prospective Diabetes Studyydemonstrated that aggressive lowering of blood pressure was accompanied by reduction of macrovascular events, Recent studies have shown that CVD morbidity and mortality associated with OM can be considerably reduced through intensified treatment of hyperlipidemia.' The incidence of coronary heart disease events is correlated to BMI. A rise in coronary events with increasing BMI over 8 years of follow-up from 31 events per 1000 at BMI <20 kg/m- to 72 per 1000 at BMI >30 kg/m? had been reported.' Studies had shown that greater degree of hyperglycemia is associated with increasing CVD mortality in individuals with diabetes.' Our study showed that CVD risk factors (smoking, hypertension, hyperlipidemia and obesity) and poor glycemic control are common in both Saudis
. and non-Saudi diabetics. Patients education regarding diabetes disease process, nutritional management, physical activity, weight loss, cessation of smoking, compliance to medication, glucose monitoring, prevention and detection of complications are of great importance. Another important issue is physician education regarding screening for CVD risk factors and initiation of early and aggressive treatment when indicated,
Received l Zth October 2002. Accepted Jar publication ill filial form 4th February 2003.
From the Department o] Medicine, King Abdul-Aziz University Hospital, Jeddah, Kingdom oj Saudi Arabia. Address correspondence and reprint requests to: Dr. Daad Akbar, Associate Professor, Consultant Physician.
ORIGINAL ARTICLES
Is hypertension well controlled in hypertensive diabetics
Daad H. Akbar, Aisha A. AI-Ghamdi
ABSTRACT
Objectives: To determine the degree of blood pressure (BP) control in hypertensive diabetics and to study the types of antihypertensive agents used for BP control.
Methods: A cross-sectional study was carried out on hypertensive diabetics followed in the outpatient clinic of King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia from January 2000 to february 2001. Patient's age, sex, duration of diabetes and its control, duration of hypertension and the type of antihypertensive agents used, were noted. Patients were classified according to the degree of systolic and diastolic BP control into 4 groups: systolic
qroup-I (140 mm Hg); diastolic group-I (90 mm Hg).
Results: A total of 230 patients were included with a mean age of 61 years and an equal male to female ratio. Mean duration of diabetes was 14 years and 9 years for hypertension. Five of 230 (2.2%) were in systolic qroup-I, 28/230 (12%) in group-II, 94/230 (41%) in group-III, 103/230 (44.8%) in group-IV; while 7/230 (3%) were in diastolic group-I, 30/230 (13%) in group-II, 92/230 (40%) in group-III, and 101/230 (43.9%) in group-IV. Angiotensin converting enzyme-inhibitors were used in 163/230 (70.9%) followed by diuretics in 99/230 (43%), Calcium channel-blockers in 62/230 (27%), and B-blockers in 25/230 (10.9%).
Conclusions: Only a small percentage of hypertensive diabetics met the recommended BP for diabetics. Efforts should be made by both patients and physician to achieve better BP control. |
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ISSN |
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9466032 |
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Journal Name |
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Saudi Medical Journal |
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Volume |
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24 |
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Issue Number |
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6 |
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Publishing Year |
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1423 AH
2003 AD |
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Article Type |
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Article |
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Added Date |
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Tuesday, January 20, 2009 |
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Researchers
| عائشة الغامدي | Alghamdi, Aisha | Researcher | Doctorate | Aalghamdius2009@hotmail.com |
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