title: Blood pressure control among patients with hypertension and newly diagnosed diabetes.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Veterans Administration, Tennessee Valley Healthcare System, Tennessee Valley Geriatric Research Education Clinical Center, VA National Quality Scholars Fellowship Program, Nashville, TN, USA.
authors.forename: N N
authors.initials: NN
authors.lastname: Choma
authors.forename: M R
authors.initials: MR
authors.lastname: Griffin
authors.forename: L A
authors.initials: LA
authors.lastname: Kaltenbach
authors.forename: R A
authors.initials: RA
authors.lastname: Greevy
authors.forename: C L
authors.initials: CL
authors.lastname: Roumie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents