Intervention project to improve control of hypertension among diabetic patients - Experience in a primary care clinic

Background: Hypertension in diabetics is a recognised risk factor for vascular disease, both of large and small vessels. Tight control of blood pressure (BP), aiming at 130/80, reduces both morbidity and mortality from vascular disease. Objective: Tight control of BP in diabetics aiming at 130/80. Target population: Type 2 diabetics with BP over 130/80, whether undergoing treatment or not, in the Shoham primary care clinic. Methods: Patients meeting the above criteria were identified by scanning their files. Their compliance to treatment and dose adjustment was followed. Preferred first line drugs were ACE inhibitors and diuretics. Results: A total of 91 of the 115 (79%) diabetics were identified as also being hypertensive. The objective of BP 130/80 or less was achieved in 26% of cases at the beginning of the research and in 53% after 6 months (p<0.001). Prior to the intervention, the average BP in the hypertensives was 142.117.6/80.6 8.3 and they were being treated with an average of 1.5+1.2 drugs. Twenty-one patients (23%) were receiving no drug treatment. After 6 months the average BP in these patients was 132.214.2/77.6 6.1 and they were being treated with an average of 2.01.2 drugs. Six (6.5%) patients were without drug treatment. The average diastolic and systolic pressure was significantly lower after the intervention (p<0.001 and p=0.001 respectively) and more anti-hypertensive drugs were being used (p=0.001). Conclusion: Through good clinical team co-operation it is possible to successfully treat hypertension in diabetics. It is important to implement the guidelines of treating hypertensive diabetics.