Diabetes, Poor Drug Compliance Predict Uncontrolled Hypertension

Internal Medicine World ReportJuly 2005

Diabetes, Poor Drug Compliance Predict Uncontrolled Hypertension

SAN FRANCISCO—Diabetes and poor medication compliance are significant

predictors of uncontrolled blood pressure (BP) in treated hypertensive

patients in the primary care setting, according to data presented at the 20th

American Society of Hypertension annual meeting that showed that only

about one third of patients with diabetes had their BP controlled. Previous data have shown that compliance with antihypertensive therapy is an important predictor of therapeutic outcome. In one study, in >50% of patients who failed to achieve goal BP, the problem was suboptimal patient drug compliance rather than an inadequate therapeutic regimen, noted Tamara Santiago,

PharmD, of the Baton Rouge Clinic AMC, Baton Rouge, La. In community settings, BP control

rates in different racial and ethnic groups ranged from 24% to 47%, which is much

worse than the control rates demonstr ted in highly controlled clinical trial settings,

noted Dr Santiago.The Baton Rouge Clinic is a multispecialty, regional medical center that provides health care services to >150,000 patients throughout the Southeast. A random

sample of 506 patients from the clinic with a primary diagnosis of hypertension was selected for retrospective medical chart review. BP control was defined as systolic BP

(SBP) <140 mm Hg and diastolic BP (DBP) <90 mm Hg; for patients with diabetes

or chronic kidney disease, it was SBP <130 mm Hg and DBP <80 mm Hg.

Overall, 61% of patients had controlled BP, but only 38% of patients with

hypertension and diabetes had their BP controlled. When factoring in age and

gender, diabetes reduced the likelihood of achieving BP control by 86%

(P <.001); poor compliance reduced it by 65%.

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