Advice on salt intake, treatment adherence could help diabetics reach goal BP
MedWire News: Primary care clinicians should emphasize the importance of dietary salt restriction and adherence to medication regimens to help patients with Type 2 diabetes achieve target blood pressure (BP) levels, research suggests.
Led by Wayne Putnam (Dalhousie University, Halifax, Canada), the study showed that a number of factors are associated with achieving target BP, with salt intake and medication adherence the most likely to be easily modified.
As reported in the journal BMC Family Practice, the team conducted a cross-sectional observational survey in practices of 27 family physicians and nurse practitioners in the Maritime provinces in Canada.
They collected data for 570 patients with Type 2 diabetes and examined characteristics associated with achieving target BP levels.
The main outcome measures were overall blood pressure (both SBP and DBP) at target (<130/<80 mmHg), systolic blood pressure (SBP) at target, and diastolic blood pressure (DBP) at target.
Multivariate analysis revealed that no predisposing or personal/family patient characteristics were significantly associated with attaining overall target BP.
Duration of hypertension and renal status were significantly associated with achieving this target, however.
The researchers also found that salt intake, a factor that can potentially be modified by healthcare interventions, was also significantly associated with meeting the target.
Indeed, patients who reported eating food low in salt were more likely to have reached the overall goal than those who did not eat low-salt foods, at an adjusted odds ratio AOR of 1.74.
The authors suggest: "A verbal 'prescription' to specifically decrease salt can accompany written prescriptions for medications. A referral to, and conversation with, a nutritionist could ensure that this is treated as a high priority by the patient."
In addition, patients who reported low (versus high) medication adherence on the Morisky Medication Adherence Scale were less likely to have achieved overall BP target, at an AOR of 0.29.
"A variety of steps can be taken in primary care that have been shown to be effective in improving adherence such as decreasing the number of daily doses, giving written directions, home or self-monitoring, and using medications with fewer side effects," Putnam and team write.
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By Sally Robertson