ANN ARBOR, Mich. Aggressive efforts to lower blood pressure in people with diabetes are paying off perhaps too well, according to a new study
The research shows that there have been dramatic improvements in blood pressure control among patients with diabetes in the U.S. Department of Veterans Affairs, with as many as 82 percent of patients having blood pressure controlled and 94 percent getting appropriate BP treatment.
However, given the dramatic rise in control, as many people now may be getting over-treated with blood pressure medications as are being under-treated.
That suggests it might be time to reconsider the current one-size-fits-all approach to blood pressure control, and turn to a new model that adjusts the blood pressure goal according to the individual, say a team of researchers from the VA Ann Arbor Healthcare System and the University of Michigan Health System.
Modern healthcare electronic record systems should help make this possible, they say, because blood pressure, prescription and other health data on individual risks such as heart disease or balance problems can all be combined.
In a paper being published online in the Archives of Internal Medicine, the team finds that over 8 percent of the 977,000 VA patients nationwide with diabetes are possibly being over-treated. Meanwhile, 6 percent were not being treated as aggressively as they could be.
"Appropriately treating blood pressure in people with diabetes is extremely important, and good blood pressure control should still be the goal to reduce risk of heart attack, stroke and other conditions," says first author Eve Kerr, M.D., director of the Center for Clinical Management Research at the VAAAHS and professor of internal medicine at the U-M Medical School.
"But just treating to a BP target in all patients may result in over-treating and harming some patients because their blood pressures actually fall too low,"
|Contact: Kara Gavin|
University of Michigan Health System