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Nurse‐led clinics for strict hypertension control are effective long term: a 7 year follow‐up study
Author(s) -
Woodward A.,
Wallymahmed M.,
Wilding J. P.,
Gill G. V.
Publication year - 2010
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2010.03039.x
Subject(s) - medicine , term (time) , intensive care medicine , pediatrics , quantum mechanics , physics
Diabet. Med. 27, 933–937 (2010) Abstract Aims The primary aim was to assess long‐term blood pressure in 110 patients with Type 2 diabetes who had achieved optimal blood pressure control during attendance at a protocol‐based nurse‐led hypertension intensive intervention clinic 7 years previously. The secondary aim was to assess modifiable cardiovascular risk factor status. Methods One hundred and ten patients who attended the clinic during 2000–2002 were selected to reattend to have their blood pressure measured to the same standard as it was during the intensive intervention clinic, by the same specialist nurse. Treatment details were recorded. Results Of the 110 patients, 36 (33%) had died; 69 (63%) of the remaining 74 patients were eligible to be contacted by letter; and 35 (51%) agreed to reattend. Age was 70 ± 9 years; 21 (60%) were male; and the duration of diabetes was 17 ± 7 years. Compared with 7 years previously, there was no difference in blood pressure control (systolic 130 ± 17 vs. 131 ± 16 mmHg, P = 0.62; diastolic 68 ± 9 vs. 65 ± 9 mmHg, P = 0.11). The number of patients with blood pressure <130/80 mmHg remained the same: 17 (49%) vs. 17 (49%; P > 0.99). During the 7 year period, 14 (40%) vs. 20 (57%) had macrovascular disease ( P = 0.23), and 14 (40%) vs. 19 (54%) microvascular disease ( P = 0.33). Thirteen (37%) vs. 18 (51%) were taking three or more antihypertensive drugs ( P = 0.33), and 26 (74%) vs. 28 (80%) angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker ( P = 0.77). Conclusions Optimal blood pressure control was sustained with no significant changes to antihypertensive medication, demonstrating the effectiveness of a protocol‐based nurse‐led clinic in achieving strict BP control.