Matige bloeddrukregulatie bij patiënten met diabetes mellitus type 2 in de eerste en tweede lijn

To investigate the degree to which the goals for adequate blood-pressure control in patients with type-2 diabetes mellitus (DM) are met in Dutch specialists’ practice and in the primary-care setting.

Design

Cross sectional.

Method

Data were collected from all consecutive patients with DM type 2 visiting the outpatient clinic of two physicians specialised in diabetes care, in Zwolle, the Netherlands, in the period 1 November 1999-30 April 2000. The target value for blood pressure was ≤ 150/85 mmHg. In addition, baseline data were collected on patients in the primary-care setting who participated in a transmural project in Zwolle in the period 1 February 1997-31 January 1998. In 1998, the target blood pressure in the primary-care setting was ≤ 160/90 mmHg. Patients who met the goals for adequate blood-pressure control were compared with patients who did not.

Results

A total of 502 patients from specialists' practice and 1084 patients from the primary-care setting were included. The prevalence of hypertension in specialists’ practice was 89 (n = 377); of these patients, 140 (37) had a good regulation of their blood pressure. The patients who had an adequate blood-pressure control and those who did not were comparable. Both groups were prescribed an average of 2.2 kinds of antihypertensive agent per patient. The prevalence of hypertension in the primary care was 69 (n = 733). The goal for adequate blood-pressure control, i.e. a blood pressure of ≤ 160/90 mmHg, was achieved in 44 (n = 324). In the primary-care setting, an average of 1.1 kinds of antihypertensive agent was prescribed, 1.6 in patients who achieved the target value and 0.8 in those who did not (p < 0.05).

Conclusion

Regulation of blood pressure in patients with type 2 DM and hypertension was far from optimal: 37 of patients in specialists' practice and 44 of those in the primary-care setting achieved the target values.