Diabetologie und Stoffwechsel 2011; 6 - P232
DOI: 10.1055/s-0031-1277503

Health care utilization in outpatients with hypertension and type 2 diabetes mellitus/impaired renal function in Germany. Results of the 3A Registry

U Zeymer 1, R Dechend 2, E Deeg 3, E Kaiser 4, S Klebs 5, J Senges 3, RE Schmieder 6
  • 1Klinikum der Stadt Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany
  • 2Charité – Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Molekulare und Klinische Kardiologie, Berlin, Germany
  • 3Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
  • 4Novartis Pharma GmbH, Clinical and Regulatory Affairs, Nürnberg, Germany
  • 5Novartis Pharma GmbH, Market Access, Nürnberg, Germany
  • 6Universitätsklinikum Erlangen, Nephrologie und Hypertensiologie, Erlangen, Germany

Aims: There is little data available about health care utilization in patients with hypertension. Therefore we used the data of the prospective 3A Registry to determine clinical events, quality of life, and health care utilization over 1 year in patients with hypertension with and without impaired renal function/diabetes mellitus.

Methods: The prospective, non-interventional 3A Registry included outpatients with newly diagnosed or known hypertension in whom the physician had decided to initiate or modify antihypertensive therapy. Patients were observed in 3 treatment arms with aliskiren, ACEi/angiotensin-receptor blockers, or treatment without RAS blockade. Patients were treated with the substances mentioned above alone or in combination with other drugs. Patients were prospectively followed for one year. All cardiovascular events, hospital admissions, rehabilitations as well as quality of life (EQ-5D) were documented.

Results: A total of nearly 15.000 patients with 1-year follow-up (FU) were analysed. 3251 patients had renal impairment (eGFR <60ml/min/1.73m2 by CKD-EPI) and 4241 patients had diabetes mellitus at baseline (BL). 38% of the patients with renal impairment had diabetes mellitus and 29% of the diabetes patients presented with impaired renal function. 8612 patients had no diabetes in combination with an eGFR ≥60ml/min/1.73m2.

The results are given in the next lines in the following order for: patients with eGFR ≥60 and no diabetes mellitus, patients with diabetes mellitus, patients with eGFR <60:

Death: 0.3%, 1.5%, 2.2%

Myocardial infarction: 0.2%, 0.4%, 0.5%

Stroke:, 0.3%, 0.5%, 0.8%

Hospital admission: 1.2%, 2.6%, 3.4%

Rehabilitation: 0.2%, 0.6%, 0.5%

Days of sick leave: 7.7±13.4, 15.8±19.9, 12.7±18.1

Number of GP contacts for hypertension: 5.0±4.1, 6.1±5.1, 5.9±5.0

Number of specialist contacts for hypertension: 2.3±2.1, 2.8±3.3, 2.8±3.2

Rating of health state at baseline (0 [worst imaginable health state] –100 [best imaginable health state]): 80 (70–90), 73.5 (60–80), 70 (60–80)

Rating of health state at follow-up (0 [worst imaginable health state] –100 [best imaginable health state]): 85 (75–90), 80 (65–89), 80 (65–85)

Conclusions: Stable outpatients with hypertension and diabetes/renal impairment have a higher health care utilization for hypertension related events during a 1-year follow-up leading to increased costs. They also report reduced quality of life than patients without these conditions. Therefore, good blood pressure control is necessary to slow down progress to lower eGFR rates, e.g. <60ml/min/1.73m2.