[Intervention project to improve control of hypertension among diabetic patients--experience in a primary care clinic].
BACKGROUND
Hypertension in diabetics is a recognised risk factor for vascular disease, both of large and small vessels. Tight control of blood pressure (BP), aiming at 130/80, reduces both morbidity and mortality from vascular disease.


OBJECTIVE
Tight control of BP in diabetics aiming at 130/80.


METHODS
Type 2 diabetics with BP over 130/80, whether undergoing treatment or not, in the Shoham primary care clinic.


METHODS
Patients meeting the above criteria were identified by scanning their files. Their compliance to treatment and dose adjustment was followed. Preferred first line drugs were ACE inhibitors and diuretics.


RESULTS
A total of 91 of the 115 (79%) diabetics were identified as also being hypertensive. The objective of BP 130/80 or less was achieved in 26% of cases at the beginning of the research and in 53% after 6 months (p<0.001). Prior to the intervention, the average BP in the hypertensives was 142.1+/-17.6/80.6+/-8.3 and they were being treated with an average of 1.5+/-1.2 drugs. Twenty-one patients (23%) were receiving no drug treatment. After 6 months the average BP in these patients was 132.2+/-14.2/77.6+/-6.1 and they were being treated with an average of 2.0+/-1.2 drugs. Six (6.5%) patients were without drug treatment. The average diastolic and systolic pressure was significantly lower after the intervention (p<0.001 and p=0.001 respectively) and more anti-hypertensive drugs were being used (p=0.001)


CONCLUSIONS
Through good clinical team co-operation it is possible to successfully treat hypertension in diabetics. It is important to implement the guidelines of treating hypertensive diabetics.
Levine
Simon Joseph
SJ
Department of Family Medicine, Central District, Clalit Health Services, Tel Aviv.
Volvovsky
Mira
M
Nakar
Sasson
S
Vinker
Shlomo
S
D000368:Aged; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D003153:Community Health Services; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D007557:Israel; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care
D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin