title: [Intervention project to improve control of hypertension among diabetic patients--experience in a primary care clinic].
abstract: 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.
authors.affiliation: Department of Family Medicine, Central District, Clalit Health Services, Tel Aviv.
authors.forename: Simon Joseph
authors.initials: SJ
authors.lastname: Levine
authors.forename: Mira
authors.initials: M
authors.lastname: Volvovsky
authors.forename: Sasson
authors.initials: S
authors.lastname: Nakar
authors.forename: Shlomo
authors.initials: S
authors.lastname: Vinker
mesh_terms: 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
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin