Treatment and control of blood pressure in patients with diabetes mellitus

Purpose. A study was conducted to characterize the prevalence of hypertension in patients with diabetes mellitus and the percentage of patients with diabetes and hypertension who achieved a targeted blood pressure goal (<135/80 mm Hg). Methods. A retrospective, cross-sectional study was conducted in an ambulatory care clinic. Eligible patients were those individuals being managed for type 2 diabetes mellitus at least once each year for two consecutive years. Blood pressure measurements that were recorded in the medical chart or written diagnoses of hypertension were used to determine the presence of comorbid hypertension. Data were collected from the chart and electronic record using a standardized form. Clinic visits over the previous 12 months were reviewed to evaluate hypertension criteria. A blood pressure of >= 135/80 mm Hg was used to define hypertension. Results. A final sample of 362 patients with type 2 diabetes mellitus was included in the study. Of these, 79% had concomitant diabetes and hypertension. Blood pressure was controlled in 175 of 270 (65%) patients. Patients who met the blood pressure goal tended to be older and weigh less than those who did not. The adjusted odds of achieving the blood pressure goal were 1.9 times higher in those patients who also achieved their low-density-lipoprotein cholesterol goal. Most patients were on at least one anti hypertensive agent; approximately 39% of the 89 patients treated with monotherapy were above the blood pressure goal. Combination therapy was used in 164 patients; approximately 32% of patients treated with combination therapy were above the blood pressure goal. Conclusion. Among ambulatory care patients with diabetes, 79% also had hypertension. Hypertension was controlled in 65% of patients with that disorder.