The level of control of cardiovascular risk factors in patients with type 2 diabetes and hypertension in the routine clinical practice of primary care physicians: results of the BEAT study

Overview

Background and aim: Patients with type 2 diabetes mellitus (T2DM) and hypertension represent a population at increased cardiovascular (CV) risk. The aim of the BEAT study was to evaluate the control of major cardiovascular risk factors in routine primary care practice in the Czech Republic. Methods: BEAT was a prospective, cross-sectional, real-world observational study running from September 2024 to October 2025. A total of 2,769 patients with T2DM and treated hypertension from 224 primary care practices were included. The achievement of guideline-recommended targets for glycated hemoglobin (HbA_1c < 53 mmol/mol), blood pressure (< 140/90 mm Hg), and LDL cholesterol according to CV risk category was assessed, together with the prevalence of complications and treatment patterns. Results: The mean age of the study population was 66.7 years and 47.8% were women. Mean body mass index was 31.7 kg/m², with obesity present in 59.2% of patients. Target HbA_1c levels were achieved by 80.9% of patients, blood pressure targets by 57.7%, and LDL cholesterol targets by only 27.2%. Simultaneous achievement of all three treatment goals was observed in only 14% of patients. Control rates progressively declined with increasing CV risk, particularly for lipid parameters. Microvascular complications were reported in 19.2% and macrovascular complications in 14.9% of patients. Lipid-lowering therapy was used by 75.4% of patients, predominantly statins, while ezetimibe was prescribed in only 6.1% of cases. Conclusions: This real-world study demonstrates suboptimal control of cardiovascular risk factors among patients with T2DM and hypertension managed in primary care. The greatest unmet needs were identified in lipid management and obesity treatment. The findings highlight the need for more intensive risk factor management, including broader use of combination lipid-lowering therapies and modern glucose-lowering agents with proven cardiovascular benefits.

Keywords:

hypertension – Primary care – type 2 diabetes mellitus – dyslipidemia – cardiovascular risk – real-world evidence – LDL cholesterol