Subramanian Usha, Hofer T P, Klamerus M L, Zikmund-Fisher B J, Heisler M, Kerr E A
Roudebush VA Medical Center, Indianapolis, IN 46202, USA.
Prim Care Diabetes. 2007 Dec;1(4):195-8. doi: 10.1016/j.pcd.2007.09.001. Epub 2007 Oct 31.
Tight blood pressure (BP) control is the single most important intervention to prevent cardiovascular mortality among patients with diabetes mellitus (DM). However, little is known about how many patients have specific target BP levels or the factors associated with patients' knowledge of these targets.
(1) To determine what proportion of patients with diabetes have BP targets; (2) To determine patient characteristics associated with having a BP target.
Cross-sectional, anonymous survey of 500 randomly selected outpatients with hypertension and DM receiving care in any Veterans Health Administration outpatient clinic in 2003. We examined multivariate associations between patient characteristics and having targets for BP. Covariates included age, race, gender, and education level; and factors specific to diabetes and BP treatment, including medication use, diabetes duration, and number of visits to diabetes healthcare providers in the previous year.
Three hundred and seventy-eight (80%) patients responded. Although most (91%) had blood glucose targets, fewer than 60% reported having a BP target. In multivariate analyses, college education was associated with having a BP target (AOR 1.97 [95% CI: 1.16-3.34]).
Less than two-thirds of diabetic, hypertensive patients had BP targets. Encouraging patients to set target BPs may promote hypertension self-management in this high-risk patient population. Less educated patients may especially benefit from interventions to increase awareness of BP targets.
严格控制血压是预防糖尿病(DM)患者心血管疾病死亡的最重要单一干预措施。然而,对于有多少患者达到特定血压目标水平,以及与患者对这些目标的知晓情况相关的因素,我们了解甚少。
(1)确定糖尿病患者中设定血压目标的比例;(2)确定与设定血压目标相关的患者特征。
2003年对在退伍军人健康管理局任何门诊接受治疗的500名随机选择的高血压合并糖尿病门诊患者进行横断面匿名调查。我们研究了患者特征与设定血压目标之间的多变量关联。协变量包括年龄、种族、性别和教育水平;以及糖尿病和血压治疗的特定因素,包括用药情况、糖尿病病程和上一年就诊糖尿病医疗服务提供者的次数。
378名(80%)患者做出回应。尽管大多数(91%)患者有血糖目标,但报告有血压目标的患者不到60%。在多变量分析中,大学教育与设定血压目标相关(比值比1.97 [95%可信区间:1.16 - 3.34])。
不到三分之二的糖尿病高血压患者有血压目标。鼓励患者设定血压目标可能会促进这一高危患者群体的高血压自我管理。受教育程度较低的患者可能尤其受益于提高对血压目标认识的干预措施。