Key result
A stepwise hypertension management algorithm increased the proportion of type 2 diabetic patients achieving blood pressure targets (≤130/80 mmHg) from 18.7% to 38.5%, though more than half still did not reach the goal.
Why the study?
Does a stepwise hypertension management algorithm improve blood pressure control in primary care patients with type 2 diabetes?
Does a stepwise hypertension management algorithm improve blood pressure control in primary care patients with type 2 diabetes?
Answers are grounded in this paper and cite their sources.
A stepwise hypertension management algorithm in primary care significantly lowered blood pressure in type 2 diabetic patients, though less than 40% achieved the strict ADA/JNC 7 target of <130/80 mmHg.
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. TRIAL REGISTRATION: ClinicalTrials.gov: NCT06260.
No takes yet. Share an insight, caveat, or question.
Viana et al. (2013) studied Type 2 diabetes and hypertension (n=107). Stepwise hypertension management algorithm vs. Baseline (single-arm study) was evaluated on Proportion of patients reaching and maintaining a blood pressure ≤130/80 mmHg (p=0.008). A stepwise hypertension management algorithm increased the proportion of type 2 diabetic patients achieving blood pressure targets (≤130/80 mmHg) from 18.7% to 38.5%, though more than half still did not reach the goal.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: