Hypertension and diabetes are two of the leading risk factors for atherosclerosis and its complications, especially heart. There is substantial overlap between diabetes and hypertension in etiology and disease mechanisms. Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways. The presence of both hypertension and diabetes mellitus confers a higher risk of cardiovascular–renal disease than the presence of either condition alone. In addition, the presence of both hypertension and diabetes mellitus makes the management of both diseases difficult and complicated.
To assess the extent of diabetic involvement towards adverse events and LOS of hypertensive hospitalized patients.
This cross-sectional study analyzes hypertensive samples which were hospitalized at National Cardiovascular Center Harapan Kita Indonesia from 2015 until mid-2016. Samples were taken consecutively among non-new ACS patients according to inclusive and exclusive criteria. Bivariate and multivariate analysis were done using SPSS-20 program.
Among 263 hypertensive samples hospitalized, the occurrence of worsening renal failure (WRF), length of stay (LOS) > 5 days, and in-hospital death were 23.2%, 62.5%, and 3.3% respectively. After adjustment with other independent variables, only diabetic status was significant in producing longer LOS (OR 2.21; p .028) and occurrence of WRF (OR 2.9; p .004). Systolic BP > 140 mmHg also had a role in worsens the renal (OR 4.13; p < .001). Likewise, admission random blood glucose level > 200 mg/dl became the only significant predictor towards in-hospital death (OR 2.4; p .017). Surprisingly, senility, anemia, LVEF and baseline s-Cr were not one of them.
In hypertensive hospitalized patients, we should pay more attentions to diabetic status and blood glucose level, not only to prevent WRF and in-hospital death, but also to shorten LOS.