Only half of hypertensive diabetics get medication switched, study shows

NORWALK Diabetics with high blood pressure have only about a 50 percent chance that their doctors will change their medications as needed or offer other treatments, according to a new study in the May 20 issue of the Annals of Internal Medicine.

“We wanted to understand when doctors would respond to an elevated blood pressure, by changing the patient’s medication or scheduling a very close follow-up,” said lead researcher Eve Kerr, an associate professor of internal medicine at the University of Michigan Medical School.

For the study, Kerr and her colleagues collected data on 1,169 people with diabetes who received care from the U.S. Veterans Administration during a one-year period. The patients were seen at nine different sites in three states.

At the start of the study, all patients had high blood pressure, which is defined as 140/90 mm Hg or higher. The blood pressure goal for people with diabetes is 130/80 mm Hg.

Among the patients in the study, 49 percent had their blood pressure treatment changed during a clinic visit. The change consisted of either a new medication, a change in dose of a current medication, or a plan to follow up within a month.

“In many ways, blood pressure is getting more attention in diabetic patients than it has in the past, which is a very good thing,” Kerr said. “But unfortunately, we found that many providers did not have a systematic approach to determining when a blood pressure was truly elevated and when medication should be changed.”

She noted that many doctors in the study only took one blood pressure reading during a patient’s visit. In some cases, when more than one reading was taken, the results weren’t compared. Also, many doctors didn’t take into consideration home blood pressure measurements reported by the patients.