ĐIỀU TRỊ THUỐC HẠ ÁP THEO KHUYẾN CÁO TRÊN NGƯỜI BỆNH ĐÁI THÁO ĐƯỜNG TYPE 2 MỚI CHẨN ĐOÁN

Abstract

Introduction: Type 2 diabetes is a common cardiovascular risk factor in Vietnam. Newly diagnosed type 2 diabetes patients require intensive management of cardiovascular risk factors, including hypertension, to reduce complications and mortality. Initiating guideline-directed antihypertensive medical treatment at diagnosis effectively controls blood pressure and improves the prognosis for these patients. Objective: This study was conducted to determine the prescription rate of antihypertensive medications according to current guidelines in newly diagnosed type 2 diabetes patients. Methods: A descriptive cross-sectional study was conducted on type 2 diabetes patients diagnosed within six months at the Endocrinology and Family Medicine clinics of the University Medical Center, Ho Chi Minh City. Prescriptions were recorded at the time of the patient's visit. Adherence to guideline-directed antihypertensive treatment was evaluated based on the 2020 guidelines from the Ministry of Health of Vietnam and the 2022 guidelines from the Vietnam National Heart Association (VNHA). Results: 275 newly diagnosed type 2 diabetes patients participated in the study. The prevalence of comorbid hypertension was 32,7%. The prescription rates of antihypertensive medications in these patients were as follows: ARB (72,2%), CCB (44,4%), beta-blockers (23,3%), diuretics (11,1%) and ACEi (8,9%). The rate of combination antihypertensive therapy was 44,4%. Among the antihypertensive regimens, ARB monotherapy was the most commonly used, with a rate of 37,8%. The proportion of patients prescribed antihypertensive medications following the 2020 Ministry of Health guidelines and the 2022 VNHA guidelines was 32,2% and 31,1%, respectively. Medications with inappropriate dosing included bisoprolol 1,25 mg, metoprolol 12,5 mg, and lercanidipine 5 mg, all prescribed at doses lower than recommended. Conclusion: Guideline-directed antihypertensive treatment in newly diagnosed type 2 diabetes patients requires further optimization, especially with early combination therapy in patients with comorbid hypertension.