"In many ways, blood pressure is getting more attention in diabetic patients than it has in the past, which is a very good thing," Kerr said. "But unfortunately, we found that many providers did not have a systematic approach to determining when a blood pressure was truly elevated and when medication should be changed."
She noted that many doctors in the study only took one blood pressure reading during a patient's visit. In some cases, when more than one reading was taken, the results weren't compared. Also, many doctors didn't take into consideration home blood pressure measurements reported by the patients.
"Without clear guidance as to how to incorporate those additional blood pressure measurements into the decision-making, it could lead to inadequate treatment of hypertension," Kerr said.
Dr. Lawrence S. Phillips, who's with the Emory University School of Medicine Division of Endocrinology and wrote an accompanying editorial in the journal, thinks doctors need to be more aggressive in treating blood pressure.
"Hypertension is a treatable problem that has a major impact on health," he said. "It's the most important health problem about which we don't do as well as we could."
One of the main problems is that doctors don't start or change therapy as often or as aggressively as they should, Phillips said. "We call that 'clinical inertia,'" he said.
Phillips thinks doctors should intensify treatment every time blood pressure is high. And blood pressure should be the first thing doctors look at during a patient's visit, and it should be treated before moving on to other problems, he said.
Patients can play a role, too, Phillips added. "Patients should ask their providers: What is my blood pressure goal? Am I at goal? If I am not, what should we do about it?" he said.
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