Appropriate Cardiovascular Prevention is Not Implemented in Diabetic Hypertensive Patients Treated in General Practice

Abstract

Introduction of guidelines and more effective cardiovascular prevention have taken place in Finland. This study clarified whether treatment of the Finnish diabetics reflects these changes. Antihypertensive, lipemic and diabetic care of diabetics in Finnish general practice was analyzed nationwide by using a questionnaire. Subjects that participated in the study were consecutive hypertensive patients that had met their general practitioners during a given week in 2006. Only 9.4 % of the diabetics reached the blood pressure target below 130/80 mmHg. Fifty-six % of the patients reached the target of glycocylated haemoglobin (GHbA1c) below 7.0 %. The low density lipoprotein (LDL) cholesterol was below 2.5 mmol/l (96.7 mg/dl) in 43.9 % of the patients. In multivariate model, young age and high GHbA1c associated with high diastolic blood pressure. Fewer patients with GHbA1c > 7 % reached the target pressure below 140/90 mmHg than those with GHbA1c ≤7.0 % (p<0.05), but no difference was found if the target was below 130/80 mmHg. Neither the number of antihypertensive agents nor home blood pressure monitoring did affect the blood pressure. Blood pressure control of the treated Finnish diabetics was poor. Metabolic targets were more commonly reached than the blood pressure target but still too seldom. The cardiovascular prevention is not implemented in Finnish diabetic patients treated in general practice.