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Assessment and management of hypertension in patients with type 2 diabetes

M C Thomas1, R Atkins

  • 1Danielle Alberti Memorial Centre for Diabetes Complications, Baker Medical Research Institute, Melbourne, Victoria, Australia.

Internal Medicine Journal
|September 6, 2008
PubMed

Insights

Hypertension management in type 2 diabetes is suboptimal, especially for high-risk patients. While blood pressure control is achievable, further efforts are needed to improve treatment rates and outcomes in Australian primary care.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Hypertension is a significant risk factor for adverse outcomes in type 2 diabetes.
  • Suboptimal blood pressure (BP) management persists, particularly in high-risk individuals.
  • This study assessed hypertension prevalence and management in Australian primary care for type 2 diabetes patients.

Purpose of the Study:

  • To estimate the frequency of hypertension in type 2 diabetes patients.
  • To evaluate antihypertensive management strategies in Australian primary care.
  • To compare BP control between two distinct patient cohorts.

Main Methods:

  • Compared BP levels and antihypertensive strategies in DEMAND (2003) and NEFRON (2005) studies.
  • Examined systolic BP and antihypertensive therapy use in patients with and without chronic kidney disease.
  • Analyzed data from 1831 (DEMAND) and 3893 (NEFRON) type 2 diabetes patients.

Main Results:

  • Over 80% of patients in both studies were hypertensive.
  • Systolic BP targets (< or =130 mmHg) were met by approximately half of treated patients.
  • Antihypertensive therapy use increased from 70.4% to 79.5% between 2003 and 2005, but remained underutilized in high-risk groups.

Conclusions:

  • Blood pressure control is achievable in Australian general practice for type 2 diabetes patients.
  • Over half of patients achieved target systolic BP (< or =130 mmHg).
  • Further BP reduction is necessary, especially for patients at high risk of adverse outcomes.
Abstract

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