Lack of effect of guideline changes on hypertension control for patients with diabetes in the U.S., 1995-2005

To study the effect of new Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) guidelines on hypertension control for patients with diabetes in the U.S. using patients without diabetes as the control group for the time trend.

The JNC VI and VII guidelines, published in 1997 and 2003, set more aggressive goal blood pressure for patients with diabetes. Data from the National Disease and Therapeutic Index, a nationally representative survey of outpatient visits in the U.S., was used to compare the difference in hypertension control (blood pressure <140/90 mmHg) between diabetic and nondiabetic visits during 1995-2005.

Hypertension control improved for both diabetic and nondiabetic visits in the study period. Compared with nondiabetic visits, there was no change in hypertension control for diabetic visits before 2001 and an approximately 4% increase afterward (P < 0.001).

The publication of new JNC guidelines did not result in substantially better hypertension control for patients with diabetes in the U.S.