Nurse-led clinics for strict hypertension control are effective long term: a 7 year follow-up study

A Woodward, M Wallymahmed, J P Wilding, G V Gill

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

AIMS: The primary aim was to assess long-term blood pressure in 110 patients with Type 2 diabetes who had achieved optimal blood pressure control during attendance at a protocol-based nurse-led hypertension intensive intervention clinic 7 years previously. The secondary aim was to assess modifiable cardiovascular risk factor status.

METHODS: One hundred and ten patients who attended the clinic during 2000-2002 were selected to reattend to have their blood pressure measured to the same standard as it was during the intensive intervention clinic, by the same specialist nurse. Treatment details were recorded.

RESULTS: Of the 110 patients, 36 (33%) had died; 69 (63%) of the remaining 74 patients were eligible to be contacted by letter; and 35 (51%) agreed to reattend. Age was 70 +/- 9 years; 21 (60%) were male; and the duration of diabetes was 17 +/- 7 years. Compared with 7 years previously, there was no difference in blood pressure control (systolic 130 +/- 17 vs. 131 +/- 16 mmHg, P = 0.62; diastolic 68 +/- 9 vs. 65 +/- 9 mmHg, P = 0.11). The number of patients with blood pressure <130/80 mmHg remained the same: 17 (49%) vs. 17 (49%; P > 0.99). During the 7 year period, 14 (40%) vs. 20 (57%) had macrovascular disease (P = 0.23), and 14 (40%) vs. 19 (54%) microvascular disease (P = 0.33). Thirteen (37%) vs. 18 (51%) were taking three or more antihypertensive drugs (P = 0.33), and 26 (74%) vs. 28 (80%) angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (P = 0.77).

CONCLUSIONS: Optimal blood pressure control was sustained with no significant changes to antihypertensive medication, demonstrating the effectiveness of a protocol-based nurse-led clinic in achieving strict BP control.

Original languageEnglish
Pages (from-to)933-7
Number of pages5
JournalDiabetic Medicine
Volume27
Issue number8
Early online date15 Jul 2010
DOIs
Publication statusPublished - Aug 2010

Keywords

  • Aged
  • Ambulatory Care Facilities/standards
  • Antihypertensive Agents/therapeutic use
  • Blood Pressure/drug effects
  • Cardiovascular Diseases/drug therapy
  • Diabetes Mellitus, Type 2/complications
  • Diabetic Angiopathies/drug therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension/drug therapy
  • Male

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