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首页> 外文期刊>BMC Family Practice >Hypertension and type 2 diabetes: What family physicians can do to improve control of blood pressure - an observational study
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Hypertension and type 2 diabetes: What family physicians can do to improve control of blood pressure - an observational study

机译：高血压和2型糖尿病：家庭医生可以采取哪些措施来改善血压控制-一项观察性研究

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Background The prevalence of type 2 diabetes is rising, and most of these patients also have hypertension, substantially increasing the risk of cardiovascular morbidity and mortality. The majority of these patients do not reach target blood pressure levels for a wide variety of reasons. When a literature review provided no clear focus for action when patients are not at target, we initiated a study to identify characteristics of patients and providers associated with achieving target BP levels in community-based practice. Methods We conducted a practice- based, cross-sectional observational and mailed survey study. The setting was the practices of 27 family physicians and nurse practitioners in 3 eastern provinces in Canada. The participants were all patients with type 2 diabetes who could understand English, were able to give consent, and would be available for follow-up for more than one year. Data were collected from each patient's medical record and from each patient and physicianurse practitioner by mailed survey. Our main outcome measures were overall blood pressure at target ( Results Fifty-four percent were at target for both systolic and diastolic pressures. Sixty-two percent were at systolic target, and 79% were at diastolic target. Patients who reported eating food low in salt had higher odds of reaching target blood pressure. Similarly, patients reporting low adherence to their medication regimen had lower odds of reaching target blood pressure. Conclusions When primary care health professionals are dealing with blood pressures above target in a patient with type 2 diabetes, they should pay particular attention to two factors. They should inquire about dietary salt intake, strongly emphasize the importance of reduction, and refer for detailed counseling if necessary. Similarly, they should inquire about adherence to the medication regimen, and employ a variety of patient-oriented strategies to improve adherence.
机译：背景2型糖尿病的患病率正在上升，这些患者中的大多数也患有高血压，从而大大增加了心血管疾病发病率和死亡率的风险。这些患者中的大多数由于各种原因未达到目标血压水平。当文献综述没有明确指出患者未达到目标时的行动重点时，我们启动了一项研究，以识别与社区实践中达到目标BP水平相关的患者和提供者的特征。方法我们进行了基于实践的横断面观察和邮寄调查研究。该环境是加拿大3个东部省份的27位家庭医生和执业护士的执业方式。参加者均为所有2型糖尿病患者，他们能听懂英语，能够表示同意，并且可以接受一年以上的随访。通过邮寄调查从每位患者的病历以及每位患者和医师/护士那里收集数据。我们的主要结局指标是总体血压达到目标（结果54％的收缩压和舒张压均达到目标。62％的收缩压达到目标，而79％的舒张压达到目标。盐具有更高的达到目标血压的几率。同样，对药物治疗依从性较低的患者达到目标血压的几率也较低。结论当初级保健专家正在处理2型糖尿病患者的血压高于目标压力时，他们应特别注意两个因素：应询问饮食中盐的摄入量，着重强调减少盐的重要性，并在必要时咨询详细的咨询意见;同样，应询问对药物治疗的依从性，并雇用各种患者导向的策略以提高依从性。

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