New Blood Pressure Guidelines Not Being Met

Despite the publication of increasingly aggressive guidelines for lowering blood pressure in people with diabetes, this condition remains substantially unimproved. The blood pressure study, which compared hypertension control in people with and without diabetes from 1995-2005, showed that reducing blood pressure goals twice for people with diabetes during the past decade did little to improve control of this condition. The findings are consistent with other recent studies which showed that doctors fail to aggressively treat high blood pressure in people with diabetes, despite the fact that hypertension is a major symptom of cardiovascular disease, the leading killer of people with diabetes.

In 1997, and again in 2003, the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC) lowered blood pressure goals for people with diabetes. They currently recommend that people with diabetes keep blood pressure at or below 130/80 mmHg.

The changes, however, "did not lead to substantially better hypertension control for diabetics compared with non-diabetic patients," the researchers concluded. "This finding is somewhat surprising considering the recognition of JNC guidelines as the gold standard for hypertension treatment, similar recommendations from other organizations such as American Diabetes Association, American College of Physicians, and American Academy of Family Physicians, and public health efforts to promote comprehensive diabetes care."

Previous studies have shown that doctors intensified treatment of high blood pressure during as few as 12 percent of office visits when people with diabetes presented with this problem. High blood pressure can be treated through lifestyle and dietary changes as well as with numerous medications. Many people with diabetes also exhibit high blood pressure, an early warning sign for the development of heart disease.

Identifying effective interventions to deal with the challenge of lowering blood pressure in people with diabetes should be a top priority for future research, the authors concluded.

Diabetes Care, Jan 2007

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