Can therapy-resistant high blood pressure increase the risk of other health complications for patients with type 1 diabetes?

This study compared patients with therapy-resistant high blood pressure (HBP) and type 1 diabetes (T1D) to those who treated HBP to examine if these patients had more health complications. The results showed that patients with resistant HBP had a greater chance of having worse T1D complications, heart disease, and stroke than those with treated HBP.

High blood pressure (HBP) causes strain on a patient’s body. This can lead to health complications, particularly in those with other health conditions such as T1D. HBP therapies are not effective for some patients (therapy-resistant). Other patients with HBP do not receive medication but are not therapy-resistant. It is unclear if there is a difference in complications experienced by patients with T1D and therapy-resistant HBP and those with non-therapy-resistant HBP.

1103 patients with T1D and HBP were examined. 18.7% of the patients had therapy-resistant HBP.  57.9% had non-therapy-resistant HBP.  23.4% had controlled HBP. Patients’ data were available for an average of 14.8 years.

Patients with therapy-resistant HBP had a 1.95 times higher risk of developing or worsening of diabetic kidney disease than those with treated HBP. Diabetic kidney disease became worse in 56.6% of those with therapy-resistant HBP over 15 years. This was compared to 24.9% of patients with non-therapy-resistant HBP and 25% of patients with controlled HBP. 

35.1% of patients with therapy-resistant HBP developed heart disease over 15 years. This was compared to 24.8% of those with non-therapy-resistant HBP and 12.8% of patients with controlled HBP. 

Patients with therapy-resistant HBP and no signs of kidney disease had a 3.5 times higher risk of stroke than those with controlled BP. After 15 years, 24.2% of patients with therapy-resistant HBP suffered from a stroke. This was compared to 14.2% of those with non-therapy-resistant HBP and 7.3% of patients with controlled HBP.

The authors concluded that patients with T1D and therapy-resistant HBP should be monitored closely for other health complications.

This study used medical records data so not all information was available, such as regular blood pressure measurements. While the study accounted for kidney disease, other health conditions may have influenced results.