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The effect of a hypertension self-management intervention on diabetes and cholesterol control

Benjamin J Powers1, Maren K Olsen, Eugene Z Oddone

  • 1Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC 27705, USA. power017@mc.duke.edu

The American Journal of Medicine
|June 30, 2009
PubMed

Insights

A tailored hypertension self-management intervention significantly improved glycosylated hemoglobin (HbA1c) in patients with diabetes. This study suggests potential "spill-over" benefits of self-management programs on comorbid chronic conditions.

Area of Science:

  • Cardiovascular Disease Management
  • Metabolic Disease Research
  • Health Intervention Studies

Background:

  • Chronic disease self-management interventions often focus on single conditions.
  • This study investigates unintended effects on comorbid conditions.
  • Hypertension management interventions are examined for their impact on diabetes and cholesterol markers.

Purpose of the Study:

  • To evaluate the impact of a tailored hypertension self-management intervention on glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C).
  • To assess the "spill-over" effects of a hypertension intervention on comorbid conditions in a randomized controlled trial.

Main Methods:

  • Utilized data from the Veterans Study to Improve the Control of Hypertension, a 2-year randomized controlled trial.
  • Compared changes in HbA1c (in diabetic subgroup) and LDL-C (in all patients with measurements) between telephone-delivered hypertension self-management and usual care groups.
  • Employed linear mixed-effects models to analyze changes in laboratory values over time between treatment groups.

Main Results:

  • The hypertension self-management intervention led to a statistically significant 0.46% reduction in HbA1c among patients with diabetes over 2 years (P = .03).
  • No significant difference was observed in LDL-C levels between the intervention and usual care groups, with a minimal between-group difference of 0.9 mg/dL (P = .79).

Conclusions:

  • A tailored hypertension self-management intervention demonstrated a significant positive effect on HbA1c, an unintended outcome.
  • The intervention did not show a significant effect on LDL-C levels.
  • Findings suggest that chronic disease self-management interventions may yield beneficial "spill-over" effects on co-occurring chronic conditions.
Abstract

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