Blood pressure control among patients with hypertension and newly diagnosed diabetes
Article first published online: 13 AUG 2012
Published 2011. This article is a US Government work and is in the public domain in the USA
Volume 29, Issue 9, pages 1126–1133, September 2012
How to Cite
Choma, N. N., Griffin, M. R., Kaltenbach, L. A., Greevy, R. A. and Roumie, C. L. (2012), Blood pressure control among patients with hypertension and newly diagnosed diabetes. Diabetic Medicine, 29: 1126–1133. doi: 10.1111/j.1464-5491.2011.03548.x
- Issue published online: 13 AUG 2012
- Article first published online: 13 AUG 2012
- Accepted manuscript online: 19 DEC 2011 03:06AM EST
- Accepted 6 December 2011
- cardiovascular disease;
Diabet. Med. 29, 1126–1133 (2012)
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.