Actively engaging patients in treatment decision making and monitoring as a strategy to improve hypertension outcomes in diabetes mellitus.

摘要

Good blood pressure (BP) control is a central outcome of high-quality diabetes care. In the landmark UK Prospective Diabetes Study (UKPDS), intensive BP control led to an absolute risk reduction of 11.2% in diabetes end points over 10 years, an effect 3.5 times greater than intensive blood glucose control. Moreover, although intensive glycemic or cholesterol control has an incremental cost-effectiveness of dollar40 000 to dollar50 000 per quality-adjusted life-year, intensive BP control actually saves almost dollar2000 per quality-adjusted life-year. For these reasons, the American Diabetes Association and the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP (JNC 7) recommend a BP goal of < 130/80 mmHg in persons with diabetes mellitus. Yet, from 47% to 70% of patients with diabetes do not achieve that goal.