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American Journal of Health-System Pharmacy, Vol. 64, Issue 1, 97-103
Copyright © 2007 by American Society of Health-System Pharmacists
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Treatment and control of blood pressure in patients with diabetes mellitus

Hae Mi Choe, Kevin A. Townsend, Gretchen Blount, Chong Houa Lo, Linda Sadowski and Connie J. Standiford

HAE MI CHOE, PHARM.D., CDE, is Clinical Pharmacist, Department of Pharmacy, University of Michigan (UM) Health System, East Ann Arbor Health Center, Ann Arbor, and Clinical Assistant Professor of Pharmacy, College of Pharmacy, UM, Ann Arbor. KEVIN A. TOWNSEND, M.S., PHARM.D., BCPS, is Clinical Education Manager, Pfizer, Inc., Chelsea, MI, and Adjunct Clinical Associate Professor of Pharmacy, College of Pharmacy, UM. GRETCHEN BLOUNT, M.P.H., PHARM.D., is Home Infusion Pharmacist, Fairlane Home Infusion —Henry Ford Health System, Southfield, MI; at the time of the study she was a Pharm.D. degree candidate, College of Pharmacy, UM. CHONG HOUA LO, PHARM.D., is Pharmacy Manager, Eckerd Pharmacy, Boiling Springs, SC; at the time of the study he was a Pharm.D. degree candidate, College of Pharmacy, UM. LINDA SADOWSKI, PHARM.D., is Staff Pharmacist, Kroger Company, Huntington, IN; at the time of the study she was a Pharm.D. degree candidate, College of Pharmacy, UM. CONNIE J. STANDIFORD, M.D., is Associate Medical Director, Ambulatory Care Services, UM, and Clinical Associate Professor of Medicine, School of Medicine, UM.

Address correspondence to Dr. Choe at the Department of Pharmacy, East Ann Arbor Health Center, 4260 Plymouth Road, Ann Arbor, MI 48109-2704 (haemi{at}umich.edu).


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 antihypertensive 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.

Index terms: Age; Ambulatory care; Combined therapy; Diabetes mellitus; Hypertension; Hypotensive agents; Weight

 



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