title: Hypertension management algorithm for type 2 diabetic patients applied in primary care.
abstract: BACKGROUND
  Hypertension frequently coexists with type 2 diabetes (DM), and increases the risk of cardiovascular outcomes. The aim of the study was to obtain/maintain blood pressure (BP) goals (ADA/JNC 7) according to a stepwise algorithm using the medication supplied by the Brazilian government.
  
  
  METHODS
  A one-year, single-arm interventional study conducted with type 2 diabetes patients. Intervention consisted of intensification of lifestyle changes and sequential prescription of drugs: diuretic; ACE inhibitors; β-adrenergic blocking agent and calcium channel blocking agent if BP >130/80 mmHg.
  
  
  RESULTS
  Seventy-eight patients completed the trial. During intervention, the number of antihypertensive tablets rose (3.6 ± 3.5 vs. 5.9 ± 3.5 pills/patient; p <0.001), as the number of antihypertensive classes increased (1.8 ± 1.0 vs. 2.70 ± 1.2; p < 0.01) and the overall drop of BP was 11 mmHg for SBP (145.0 ± 22.8 vs. 133.7 ± 20.9 mmHg; p < 0.01) and 5 mmHg for DBP (78.7 ± 11.5 vs. 73.7 ± 10.5 mmHg; p = 0.001). Although the number of patients with BP in target almost doubled [14 (18.7%) vs. 30 (38.5%) p = 0.008], less than 40% of the patients achieved the proposed goals.
  
  
  CONCLUSIONS
  A BP algorithm applied to type 2 diabetic and hypertensive patients is able to lower BP, however more than half of the patients did not achieve the ADA/JNC 7 targets demonstrating the complexity of BP control in this population.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT06260.
authors.affiliation: Endocrine Division and Primary Care Unit of Hospital de Clinicas de Porto Alegre and Federal University of Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil. vercoza@yahoo.com.
authors.forename: Luciana V
authors.initials: LV
authors.lastname: Viana
authors.forename: Cristiane B
authors.initials: CB
authors.lastname: Leitão
authors.forename: Maria F
authors.initials: MF
authors.lastname: Grillo
authors.forename: Ennio P C C
authors.initials: EP
authors.lastname: Rocha
authors.forename: Juliana K
authors.initials: JK
authors.lastname: Brenner
authors.forename: Rogerio
authors.initials: R
authors.lastname: Friedman
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Gross
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