title: Characteristics and blood pressure management in patients with and without diabetes in primary care in rural Victoria.
abstract: OBJECTIVE
  This study tested whether diabetic hypertensive patients receive more intensive BP management than hypertensive patients without diabetes.
  
  
  METHODS
  A 12 month retrospective review of BP management was undertaken among 2460 hypertensive patients (335 with diabetes), aged 40-79 years from randomly selected general practices in rural Australia.
  
  
  RESULTS
  Prevalent diagnosed cardiovascular disease (CVD) was commoner among diabetic than non-diabetic patients (27.2% vs. 16.0%, OR 1.82 (1.39-2.39)). The proportion with a BP<130/80 mmHg was low (22.9% vs. 18.6%, p=.069, respectively). BP was monitored more closely among diabetic patients (e.g. quarterly BP measurements in 18.2% vs. 10.5% respectively, p<.001), was treated with more anti-hypertensive agents (1.5+/-1.0 vs. 1.0+/-1.0, p<001) and was more likely to be associated with other CVD medications. Achievement of non-diabetic BP targets was associated with living in the regional centre (vs. smaller rural town: 1.21 (1.02-1.43)) and CVD (1.54 (1.21-1.95)), but not the presence of diabetes (0.94 (0.73-1.19)).
  
  
  CONCLUSIONS
  In this population, hypertension is more aggressively monitored and treated among diabetic than non-diabetic patients, but largely due to their CVD and not to the level recommended in guidelines. Commencing anti-hypertensive treatment earlier (e.g. at diagnosis) and recommending more agents (e.g. in combination) may be needed to improve BP control among diabetic patients on a population basis.
authors.affiliation: Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. dsworkster@gmail.com
authors.forename: David
authors.initials: D
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003971:Diastole; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D013599:Systole; D014739:Victoria / Q000453:epidemiology