Email updates

Keep up to date with the latest news and content from Diabetology & Metabolic Syndrome and BioMed Central.

Open Access Research

Hypertension management algorithm for type 2 diabetic patients applied in primary care

Luciana V Viana*, Cristiane B Leitão, Maria F Grillo, Ennio P C C Rocha, Juliana K Brenner, Rogerio Friedman and Jorge L Gross

Author Affiliations

Endocrine Division and Primary Care Unit of Hospital de Clinicas de Porto Alegre and Federal University of Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil

For all author emails, please log on.

Diabetology & Metabolic Syndrome 2013, 5:52  doi:10.1186/1758-5996-5-52

Published: 12 September 2013

Abstract

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

Keywords:
Type 2 diabetes; Hypertension; JNC 7; ADA guidelines; ‘Real life’