| The purpose of this study was to evaluate the adequacy of blood pressure control and utilization patterns of antihypertensive agents among patients with dual diagnoses of hypertension and Diabetes Mellitus type 2 seen in a primary care clinic during the calendar year 2008. Adequacy of blood pressure control was determined per recommendations of JNC7 antihypertension guidelines, which state that diabetics with hypertension need to have blood pressures controlled to less than 130/80.;Demographic results showed that 68% of patients were over the age of 65, 30% were between the ages of 50 and 64 and 2% were between the ages of 20--49. The sample was primarily male (99%), of white race (97%), and married (69%). Forty-two percent of the participants met JNC7 criteria and had both systolic and diastolic blood pressure measurements controlled to less than 130/80 mm Hg. Forty percent of participants had either the systolic or the diastolic measurement controlled. Eighteen percent had neither systolic or diastolic measurements controlled. Most commonly utilized antihypertensive medications in order of their frequency were ACE/ARBs (70%), beta blockers (59%), calcium channel blockers (38%), thiazide diuretics (36%), loop diuretics (28%) alpha blockers (27%) combination antihypertensives (6%) and miscellaneous agents (5%). Body mass index (BMI) showed the participants were morbidly obese (11%), obese (52%), overweight (30%), normal weight (7%), and below normal weight (4%). Only 44% of patients had a microalbuminuria test documented during the year. In summation, only 42% had blood pressures controlled to the criteria specified for diabetic hypertension per JNC7 antihypertensive guidelines. ACE/ARB medication use was the highest utilized antihypertensive medication (70%), which was expected as this class of medication is recommended for diabetics; however, thiazide diuretics which are indicated as a first line therapy were only prescribed to 36% of the sample. Lifestyle modifications especially need to be emphazised by providers to control blood pressure and diabetes as obesity and overweight rates were very high. Further recommendations include obtaining a microalbuminuria laboratory test annually. |
