Blood pressure levels are ‘unacceptably high’ in children and young adults with type 1 diabetes according to researchers who say their findings highlight the need for regular monitoring of BP during diabetes-related healthcare consultations.
One in five young people with T1D have BP levels in the hypertensive range, according to a retrospective review of BP data for 6338 adolescents and young adults (age 16-25) participating in the Australasian Diabetes Data Network registry.
The data obtained from 24 participating centres and covering 36,655 T1D healthcare visits showed that 19.4% of under 18s and 21.7% of those aged over 18 years had BP levels in the hypertensive range.
Hypertension was defined as systolic BP and/or diastolic BP >95th percentile for children under the age of 18 and BP of > 130 and/or diastolic BP>80 mmHg for young adults age ≥18 years, on at least three occasions.
In their paper published in Acta Diabetologica (link), researchers from the University of the Sunshine Coast and University of Melbourne said the registry data also highlighted the early development of cardiovascular and metabolic risk factors in children with T1D.
With an average age of 18 and an average duration of T1D of around nine years, 42% of registry subjects had BMI in the overweight or obese range.
In all age groups, the risk of having BP in the hypertensive range was associated with male sex, injection (vs. pump) therapy, higher HbA1c, and higher BMI.
The researchers said the high proportion of young people with hypertension was cause for concern, especially as they appeared to be occurring from young ages.
“[These] findings flag the additive contribution of hypertension to the well-established body of evidence indicating a need to review healthcare models for adolescents and young adults with T1D,” they wrote.
They noted that BP was only routinely recorded in 39.5% of healthcare visits by young people under 18 and in 52.6% of visits by those aged ≥18 years, despite annual screening being recommended in Australian clinical care guidelines for T1D in children, adolescents and adults.
“Altogether, these data indicate a pressing need to improve [BP] management and treatment to target levels in this vulnerable population,” they said.
“Targeting modifiable risk factors such as glycaemic control and overweight/obesity may lead to a reduction in the burden of hypertension and its potential long-term morbidity and mortality in this population,” they added.