The current status of home and office blood pressure control among hypertensive patients with diabetes mellitus: the Japan Home Versus Office Blood Pressure Measurement Evaluation (J-HOME) study.
Although self-measured blood pressure (BP) at home (HBP) has become popular in clinical practice, little information is available regarding the proportion of diabetic patients with properly controlled HBP. We evaluated the status of HBP control in diabetic hypertensives. HBP control status was cross-sectionally evaluated among 3400 essential hypertensives taking antihypertensive treatment. Of these, 466 (14%) had diabetes. Physicians evaluated the subjects' HBP control as "poor", "fairly good", or "excellent" using a self-administered questionnaire. When the HBP threshold in diabetic patients was set tentatively at 130/80 mmHg or 135/85 mmHg, HBP was properly controlled in 18% or 30% of diabetic patients, respectively. The same trend was observed in office BP. The average number of drugs prescribed for diabetic patients was 2.0 drugs. In the majority of diabetic patients with uncontrolled BP, the BP control status in two-thirds of those was evaluated as "excellent" or "fairly good" by their physicians. In Japan, HBP and office BP were not adequately controlled in most diabetic hypertensives. The main reason for this would appear to be a lack of intensive treatment and a lack of recognition by physicians that their patients' BP was insufficiently controlled.
Obara
Taku
T
Department of Clinical Pharmacology, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, Sendai, Japan.
Ohkubo
Takayoshi
T
Kikuya
Masahiro
M
Asayama
Kei
K
Metoki
Hirohito
H
Inoue
Ryusuke
R
Oikawa
Takuya
T
Murai
Kayo
K
Komai
Rie
R
Horikawa
Tsuyoshi
T
Hashimoto
Junichiro
J
Totsune
Kazuhito
K
Imai
Yutaka
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods / Q000592:standards; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006699:Home Care Services / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents