Frequent physician visits beneficial for patients with diabetes to lower blood pressure

Patients with diabetes who frequently visited the primary care physician had quicker, more dramatic normalization of blood pressure, according to new data.

Researchers performed a retrospective cohort study that followed 5,042 hypertensive patients with diabetes between 2000 and 2005. The researchers used 129 mm Hg as the recommended treatment goal for systolic BP and 84 mm Hg for diastolic BP, as recommended in guidelines published before the study.

Patients visiting their primary care physician at intervals of one month or less experienced normalization of BP after a median 1.5 months, for a decline of 28.7 mm Hg per month (P<.0001). Patients who waited more than one month between physician visits did not experience normalization of BP until after 12.2 months, which equated to a decline of 2.6 mm Hg per month (P<.0001).

The greatest benefits in BP change occurred in patients who visited their physician in two-week intervals — a shorter interval than current guidelines recommend. These patients reached BP normalization in 0.7 months (P<.0001). Patients who visited their physician at intervals ranging from two weeks to one month reached normal BP levels in 1.9 months (P<.0001).

Longer periods between physician visits were associated with decreased rates of change in BP. When visiting a physician every one to two weeks, the rates of decrease for systolic and diastolic BP were 43.8 mm Hg and 13.1 mm Hg per month, respectively. Visits every six months resulted in rates of 0.9 mm Hg per month for systolic BP and 0.4 mm Hg per month for diastolic BP.

“Both the physicians and the patients with elevated BP should take steps toward more frequent communication — whether face-to-face or otherwise,” Alexander Turchin, MD, assistant professor of medicine at Harvard Medical School and director of Informatics Research in the division of endocrinology at Brigham and Women’s Hospital, said in a press release.

Turchin A. Hypertension. 2010;56:doi:10.1161/HYPERTENSIONAHA.109.148791.