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Blood pressure control among patients with hypertension and newly diagnosed diabetes
Author(s) -
Choma N. N.,
Griffin M. R.,
Kaltenbach L. A.,
Greevy R. A.,
Roumie C. L.
Publication year - 2012
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.1464-5491.2011.03548.x
Subject(s) - medicine , blood pressure , diabetes mellitus , veterans affairs , cohort , retrospective cohort study , guideline , prehypertension , cohort study , surgery , endocrinology , pathology
Diabet. Med. 29, 1126–1133 (2012) Abstract Aims To determine the proportion of patients who achieved blood pressure control during the 2 years following new diabetes diagnosis. Methods A retrospective cohort of veterans ≥ 18 years with hypertension who initiated a diabetes medication from 2000 to 2007 in the Veterans Administration Mid‐South Network was assembled. Blood pressure control at diabetes treatment initiation (baseline) was compared with blood pressure control 6, 12, 18 and 24 months later. The Veterans Affairs and American Diabetes Association definitions of control, ≤ 140/90 and ≤ 130/80 mmHg, respectively, were primary and secondary outcomes. Results At baseline, 59.5% of 16 182 patients had controlled blood pressure according to the Veterans Affairs guideline (31.5% using American Diabetes Association definition). Six months following initiation of diabetes treatment, 65.7% had their blood pressure controlled ( P < 0.001). Blood pressure control was sustained but not further improved between 6 months and 2 years, with 66.5% controlled at 2 years following baseline. Higher initial systolic blood pressure, black race and hospitalization in the previous year were associated with higher likelihood of uncontrolled blood pressure at 6 months; whereas baseline cardiovascular disease, baseline dementia and later year of cohort entry were associated with lower likelihood of uncontrolled blood pressure. Conclusion We found an increase in blood pressure control in the 6 months following initiation of diabetes treatment. However, overall blood pressure control remained suboptimal and with no further improvement over the next 18 months.